Overview
- A JAMA Network Open analysis identified 372 distinct emojis in 4,162 notes across 218.1 million electronic health records from 2020 to 2025.
- Emoji use, though rare, increased from fewer than two notes per 100,000 in 2020–2024 to more than 10 per 100,000 by late 2025.
- Most instances appeared in clinician-to-patient portal messages; the patient portal does not allow direct emoji entry, so patient emojis were typically copied from emails or texts.
- Smileys and emoticons accounted for 58.5% of emoji types, with the smiling face with smiling eyes used 1,772 times; about 41% appeared to be template elements and roughly 60% conveyed emotion.
- Michigan Medicine’s health information team plans to explicitly include emojis in its anti-symbol policy, and researchers call for institutional guidance and further study on comprehension, trust, and legal risk.