The use of emojis in medical records appears to be on the upswing, according to a new study showing the most popular characters used by clinicians in notes.
Researchers from the University of Michigan found that from 2020-2024, about 1.4 notes per 100,000 they reviewed contained emojis. By the third quarter of 2025, that number had soared to 10.7 notes per 100,000.
The data were published in JAMA Network as a research letter.
Just under two-thirds of notes in medical records using emojis (64%) were intended for patients. About one-third of the emoji-containing notes were intended for the clinical team.
Researchers found that notes in the study contained 372 different emojis. Notes containing emojis used an average of four of the characters.
The top emoji (used in about 40% of notes with the characters) was a smiling face with smiling eyes. The second most popular character (used in 13% of notes) was an old-fashioned telephone receiver. The third most used was a calendar icon, appearing in 10% of notes.
Other notes included characters like a maple leaf, a bathtub and a briefcase.
Emojis expressing some kind of emotion (faces that were smiling, winking and grimacing, for example) accounted for 58% of characters in the notes researchers examined. Emojis of objects (a rainbow and fire, for example) accounted for 21.2%, while characters expressing people and bodies were the third most common: 17.6%.
The most common types of notes containing emojis were portal messages sent to patients. Telephone encounters were the second most common type of note to use emojis (28.5%). Encounter summaries came in third (15.3%), progress notes were fourth (13.9%) and patient instructions followed (6.4%.)
Researchers noted that the Epic patient portal used by the study site restricts patient notes from using emojis, so they found none of the characters in patient portal messages. One researcher also told MedPage Today that while use of emojis remains fairly low in patient notes, he was surprised to find as much activity as the team found.
For more information, see the full text of the JAMA Network research letter.
