Problem lists are essential for patient care, and help organize providers' approach on essential issues as well as both communicate and document them. In an electronic, meaningful use era, problem lists have become filled with redundancies, entities with little clinical value and old problems which should have been resolved. This presentation combines data from 4 different health, large systems - an analysis of nearly 20 million problems on about 2 million patients to examine these issues and demonstrate a solution. Depending on the size of the list, about 20-40% of the problems could be cleaned-up, helping improve clinical decision making, lowering legal risks, reducing provider time spent in the EHR and decreasing provider burn out. Our organization has created tools to perform this clean up in their EHR. This approach and lessons learned will be shared for other institutions attempting to do the same as well as the implication for EHR problem list design.