📋 The EPIC Pasteboard (Archive #1)

Pick up the crumbs from all over the chart.

Note: (This was originally posted on Twitter September 2022 - I will be adding these tweet threads to substack so they are here for reference)

How it all began

I probably use the EPIC pasteboard function dozens of times each clinic day.

It’s my go-to secret sauce for precharting.

If I ever have a medical student or resident in my clinic, I teach them. I tell colleagues. I am amazed to find nearly nobody knows about it before I spill the beans.

Maybe you found out about it in your training? I certainly didn’t.

What is the pasteboard?

In simple terms, it’s copy/paste. Here’s how I introduced it. It’s a simple but powerful productivity hack.

𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 @CanesDavid

⚠⚠⚠ If your hospital/clinic uses EPIC, and you don't know the command 'Control + E'... ...then you may be missing out on a major productivity hack. 🧵

So it’s copy/paste?

Well, it’s supercharged copy/paste. We can get into a separate debate as to whether copy/paste is good or evil. A recent JAMA article elegantly examined the hazards of poorly executed copy/paste here.

𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 @CanesDavid

What's Control E? The EPIC Pasteboard. It's Copy/Paste, but 10 things can fit on the clipboard, which "remembers" all of the copied snippets you chose (even if they contain images).

It’s supercharged copy/paste, because it has a 10-entry memory. And by the way - pro tip - that memory is forever.

Log into that same patient’s chart in a year, and your pasteboard will still be there (others can’t see it).

Breadcrumbs

Pick up the crumbs, and dump them into your note.

𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 @CanesDavid

So as you prepare a note - poke around the chart, highlight all the crumbs you want for your note, and hit Ctrl+E. For example: -The date of the CT scan, the scan title, and the impression (highlight just those, Ctrl+E on each) -Your Op note date, name of procedure -etc

What are some other examples of great pasteboard fodder?

• Any radiology report (just the necessary stuff)

• Pathology reports - grab the TNM stage and grade, leave all the fluff behind

• A colleague’s consult note - just the date, their name, and pithy parts of their plan.

• A singular result, that won’t auto-pull using smart links (a urology example is stone composition from a stone analysis, for instance)

How do you drop the breadcrumbs?

You’ll notice that after you hit ‘Ctrl+E’ to pick up something you’ve highlighted, when you get to your note, the pasteboard is gone.

The key is to hit ‘Ctrl+E’ again when your cursor is in blank space in your note.

Voila! The pasteboard reappears.

𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 @CanesDavid

Then go to your note, hit Ctrl+E in blank space, the board pops up, and you can sequentially paste 📋multiple items into your note. Think of this part as dropping all the breadcrumbs you picked up while reviewing the chart.

---

How do you use the EPIC pasteboard in your workflow?

Alternatively, do you hate the idea?

Let me know. I read every single comment.