Crowdsourced point-of-care knowledge

A platform for collaborative editing of efficient, evidence-based medical dotphrases and templates.

WHAT IS A DOTPHRASE?

A dotphrase is a colloquial term for a preformed block of text that is inserted using keyboard shortcuts, often preceded by a dot. For example ".LBP" might pull in a block of text related to low back pain. Most EHRs have this capability, both for organization-level and individual user-created content.

CHALLENGES

CHALLENGES OF CURRENT PRACTICE ENVIRONMENT

Documentation is inefficient, arduous and not evidence-based. Providers currently spend more time documenting than seeing patients and are frustrated with the status quo. Dotphrases have the potential to achieve improved efficiency and evidence-based care, and reduce provider burnout.

CHALLENGES WITH CURRENT DOTPHRASE USE

Most dotphrases in use today are one-offs made by individuals with many limitations: • They lack evidence base or peer review. • They are siloed in individual users' accounts, not easily accessible to wider communities for use or collaborative editing. • They are difficult to organize or recall (especially in large numbers).

OPPORTUNITIES: WHY USE DOTPHRASES?

POINT OF CARE DECISION SUPPORT

A dotphrase can function as a decision support tool, efficiently bringing relevant, evidence-based information into the clinical encounter, at the exact time that key management decisions are made and diagnostics/therapeutics ordered (eg, should I prescribe antibiotics for sinusitis or order an MRI for back pain).

EFFICIENCY

Clinicians spend more time documenting than seeing patients. Yet, high quality, complete notes serve a variety of purposes including communication with other providers as well as meeting medical-legal and billing requirements. Thoughtfully designed dotphrases can help fulfill all of these functions while maximizing time with patients.

EDUCATION

Well-crafted dotphrases can serve as a succinct learning opportunity for trainees. They can highlight important elements in evaluation of particular complaints and externalize expert clinicians' implicit algorithms. They can serve as a useful hedge against cognitive errors, for example reminding clinicians to consider less common diagnoses and avoid premature closure.

TEAM

PATRICK SANGER, MD PhD

Patrick grew up in Fort Lauderdale, FL. He studied architecture at Yale University then obtained an MD/PhD in biomedical informatics at the University of Washington, Seattle. He completed a primary care internal medicine residency at UCSF in 2020. He plans to practice primary care while developing technologies to facilitate patient-centered chronic disease management.

ERIC LEE, MD MBA

Eric is originally from Phoenix, Arizona. He majored in biology at Brown University, and went on to obtain a joint MD MBA at Yale University. He completed a categorical internal medicine residency at UCSF in 2020, and is pursuing a career in hospital medicine. He is primarily interested in harnessing electronic medical records to optimize the quality and delivery of care.

NAT GLEASON, MD

Nat is Associate Professor of Clinical Medicine in the Division of General Internal Medicine where he practices as a primary care physician and teaches medical students and residents. He serves as Medical Director for Practice Innovation for UCSF Health, focusing innovations that improve access to timely, high-value care in the outpatient setting.