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1 We hope this list of smart phrases helps make creating your Epic note templates a bit easier. Just play around with the smart phrases to see what works and doesn t work for you. You are also welcome to distribute this to anyone else who would find it useful If you would like to receive periodic updates by as they are made to this document, just Gopal at: and he will send out periodic updates from time to time OR You can find the latest update at: We anticipate updating this list at least weekly for the next few months. Best, Gopal, John and Valery Encounter Date: Encounter Date: Mr/Mrs: Names: Inserts Mr. XX is a XX year old XX: Age: Sex: DOB: MR: AUTHOR: 1

2 PHRASES: he/she He/She His/her His/Her him/her Him/Her PATIENT CONTACT INFORMATION: Patient Contact Information: Patient Emergency Contact Information: Patient Address: 2

3 E&M ELEMENTS: CURRENT PROBLEM LIST: PAST MEDICAL HISTORY: PAST SURGICAL HISTORY: FAMILY HISTORY: SOCIAL HISTORY: (Our favorite because it refreshes if the information changes before the note is signed) (Does not refresh) (Does not refresh) TOBHX ALCHX DRUGHX OCCUPATION HISTORY: CURRENT HOSPITAL MEDICATIONS: CURRENT OUTPATIENT MEDICATIONS: ALLERGIES: 3

4 LAB RESULTS: CHEMISTRY 72 HOUR HISTORY: (Our Favorite puts all labs into a nice table with rows but only pulls in 72h worth of (Pulls in the last value change the 1 to whatever number you want) @LABALLVALUES(BUN:1,CREATININE:5,NA:5,K:5,CO2:5,CL:5,GLU:5,CA:5, MG:5, CBC 72 HOUR YMPHP:*,MONOSP:*,EOSP:*,BASOP:*,NEUTABS:*,LYMPHABS:*,MONOABS:*,EOSA (Our Favorite puts all labs into a nice table with rows but only pulls in 72h worth of P:1,LYMPHP:1,MONOSP:1,EOSP:1,BASOP:1,NEUTABS:1,LYMPHABS:1,MONOABS: (Pulls in the last value change the 1 to whatever number you want) OTHER CBCs: COAGULATION (Pulls in the last value change the 1 to whatever number you want) MISC LABS: 4

5 CARDIAC MARKERS: LIPID PANEL: OTHER / TOXICOLOGY: PSA: URINE RESULTS: URINALYSIS: URINE URINE NZODIAZ:1,UCOC:1,UTHC:1,UOPIATES:1,UPCP:1,UPROPX:1,UMETHADONE:1,UCR RADIOLOGY RESULTS: LATEST RADIOLOGY RESULTS: ECG RHYTHM: {EKG IP SH:112945}. PERTINENT ECHOCARDIOGRAM FINDINGS: {ECHO IP SH:112946}. 5

6 VITAL SIGNS AND PHYSICAL EXAM: VITAL SIGNS: TEMPERATURE HISTORY 24H: TEMPERATURE HISTORY 72H: TEMPERATURE HISTORY 96H: BLOOD PRESSURE HISTORY: I&O: RRIOCURSHIFT IOBRIEF PHYSICAL EXAMINATION ELEMENTS: VITAL SIGNS: CURRENT WEIGHT: BMI: PREVIOUS WEIGHTS: PERFORMANCE STATUS (ECOG): {.:114378} GENERAL: {.: ::"well- nourished, well- developed"} {.: ::"in no acute distress"}. SKIN: {.: ::"Warm and dry and without jaundice, ecchymoses, or petechiae"}. HEENT: {.:124935::"Normocephalic","anicteric sclera","moist mucous membranes","no oral lesions"} NODES: {.: ::"No appreciable adenopathy in the bilat cervical, submandibular, supraclavicular, axillary, or inguinal regions."}. LUNGS: {.:113648::"good inspiratory effort","clear bilaterally"}. CARDIAC: {.: ::"Regular rate and rhythm, without murmurs, rubs or gallops"}. ABDOMINAL: {.: ::"Normal bowel sounds. Soft, without tenderness, masses or hepatosplenomegaly"}. MUSKL: ROM to {.:106190} {.: } extremity {.:102204::"excellent"}. GENITALS: {ONC GENITALS CB: ::"Deferred"}. RECTAL: {.:124937} EXTREMITIES: {.:124940}. NEUROLOGIC: {.:124941::"Alert and oriented x3. Gait normal. Reflexes normal and symmetric. Sensation grossly normal"}. (This is only one example there are many variations) 6

7 SIGNATURES: SIGNATURE: CC: 7

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