1. Your dotphrase can contain any/all of Subjective (eg HPI), Objective (Physical Exam, Labs), Assessment/Plan (short and/or long versions), Patient Education, or Admin/Other. It can address a known diagnosis or an undifferentiated complaint. Encourage focusing on Assessment/Plan since this is the most challenging and not many existing dotphrases cover this.

2. Please include evidence where appropriate, e.g.:

  – for HPI and PE elements, cite likelihood ratios or sensitivity/specificity

  – for assessment/plan, cite NNT/NNH for treatments and/or clinical decision rules

  – cite references (by typing {ref}this is the reference{/ref} but with square [] brackets instead of curly {} brackets)

  – include links to shared decision aids in plan

3. Write text in such a way as it can be directly used without editing, (eg, “The patient denied x, y, z” rather than “x, y, z?”)

4. If HPI/PE/AP have significant branch points, (eg, micro/normo/macrocytic anemia or HFpEF/HFrEF), indicate that and write separate text that is appropriate to each with the understanding that the other branches’ text can be deleted.

5. For plans, try to include first, second and/or third line workup.

Comments, questions or edits for this guide? Email admin@dotphrase.org