An espanso package to help with medical documentation
With ever increasing demands on physician time, we need to make use of technology to increase efficiency. If we can spend less time on typing, we can spend more time listening and caring for our patients.
Many electronic medical records (EMRs) provide the ability to create templates or stamps. Some of these functions actually work pretty well within each system. However, they all require considerable investment in time to set up, and collaboration on development is limited. Templates may be shared within a clinic but seldom more widely.
Using a tool like espanso allows us to define templates/stamps and automatic text expansion independent of any EMR. This means you can document in a similar manner across different sites, even if they are using different EMRs. It also means a community of interested individuals can collaborate to create a library that is likely to be more complete and useful than anything any individual can maintain on their own.
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Install espanso
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Install medical-docs package
espanso install medical-docs -
Add the following to your default.yml Hint: found in the Config directory as listed by
espanso path
# use clipboard to insert text
# should be smoother operation unless your application can't accept
# input from clipboard
# backend: "Clipboard"
# global variables
global_vars:
# clinic name to be included as appropriate
- name: "cname"
type: "dummy"
params:
echo: "My Clinic Name"
# your name to be included as appropriate
- name: "myname"
type: "dummy"
params:
echo: "Dr. Bill Ressl"
# your email to be included as appropriate
- name: "myemail"
type: "dummy"
params:
echo: "wressl@gmail.com"
# your phone number to be included as appropriate
- name: "myphone"
type: "dummy"
params:
echo: "1-800-123-4567"
# Some prefixes to implement patient facing documentation
# chief complaint prefix: headache -> Your main concern today is headache
- name: "cc"
type: "dummy"
params:
echo: "Your main concern today is"
# symptom prefix: no headache -> You have no headache
- name: "sp"
type: "dummy"
params:
echo: "You have"
# symptom prefix: normal blood pressure -> You have normal blood pressure
- name: "op"
type: "dummy"
params:
echo: "You have"
# symptom prefix: strep throat -> Your most likely diagnosis is strep throat
- name: "ap"
type: "dummy"
params:
echo: "Based on today's assessment, the most likely diagnosis is"
# plan prefix: follow-up in 3 days -> You are recommended to follow-up in 3 days
- name: "pp"
type: "dummy"
params:
echo: "You are recommended to"
# covid website: local self-assessment site to request testing
- name: "covidwebsite"
type: "dummy"
params:
echo: "https://myhealth.alberta.ca/Journey/COVID-19"
# find a family physician website: local
- name: "findfpwebsite"
type: "dummy"
params:
echo: "https://albertafindadoctor.ca/"
matches:
# instructions on how to get your prescription
- trigger: ":rxget"
word: true
replace: |
Once your prescription has been written, you will receive a
notification on your app.
You then need to acknowledge the notification and select a pharmacy
where the prescription will be sent.
You need to select the pharmacy EVERY TIME you receive a prescription.- restart espanso
Macintosh-2:~ wressl$ espanso restart
Daemon started correctly!
If the installation worked correctly, you should be able to start typing with auto-magical results.
For example:
Macintosh-2:~ wressl$ xr
as soon as you hit space, turns into
Macintosh-2:~ wressl$ x-ray
Here is a list of all the current available expansions:
| Simple Abbreviations | Expansion |
|---|---|
| A: | Assessment: |
| amit | Amitriptyline (Elavil) |
| appt | appointment |
| bcp | birth control pill |
| :bid | twice daily |
| bmd | bone mineral density |
| bp | blood pressure |
| :cp | chest pain |
| cpl | Please copy the following link into your browser: |
| cv | COVID-19 |
| cxr | chest X-ray |
| ds | drug-store |
| EOM | extraocular movements (EOM) |
| fit test | FIT test (colon cancer screen) |
| fp | Family Physician |
| f/u | follow-up |
| hr | hours |
| labreq | Laboratory Requisition |
| Lt | Left |
| llq | left lower abdomen |
| lmp | last menstrual period |
| luq | left upper abdomen |
| mo | months |
| mammo | mammogram |
| min | minutes |
| :mycl | your clinic name |
| :myem | your email address |
| :myn | your name |
| :myph | your phone number |
| nc | Alberta Netcare |
| nort | Nortriptyline (Avantyl) |
| O: | Objective: |
| ocp | oral contraceptive pill |
| :od | once daily |
| oeph | On examination of the photo provided, |
| otc | over-the-counter |
| P: | Plan: |
| PERRLA | pupils equal, round, reactive to light and accomodation (PERRLA) |
| pf | puffs |
| pn | BC PharmaNet |
| prn | as needed |
| :qhs | at bed-time |
| :qid | four times daily |
| Rt | Right |
| rlq | right lower abdomen |
| ruq | right upper abdomen |
| rx | prescription |
| rxhld | Please do not fill until requested by patient |
| S: | Subjective: |
| sob | shortness of breath |
| sec | seconds |
| soboe | shortness of breath on exertion |
| :temp | temperature |
| :tid | three times daily |
| trx | Please take medication(s) prescribed as directed |
| u/s | ultrasound |
| valt | Valacyclovir (Valtrex) |
| vrx | 2-4 puffs four times daily as needed |
| vutd | vaccinations are up to date |
| wic | walk-in clinic |
| wk | weeks |
| ya | You are at home in |
| yaa | You are at home in XXXX accompanied by your mother XXXX |
| yar | You are advised to |
| yfut | Your main concern today is to follow-up on test results |
| yh | You have had |
| ym | Your main concern today is |
| ymed | Your current medications include |
| ymnd | You were accompanied by your mom and dad |
| ymhx | Your medical history significantly includes |
| yn | You have had no |
| ynhx | You have no previous significant medical history, no prescription medications and no relevant family history |
| yr | years |
| yrx | You are requesting a prescription for |
| yw | You appear well, with no apparent distress |
| xr | x-ray |
| Components | Description |
|---|---|
| :arcause | Causes of arrhythmia (6Hs,5Ts) |
| :asthma | Asthma ICS start |
| :cage | CAGE screen for ETOH abuse |
| :cialis | Cialis (tadalafil) start |
| :covidredflags | Covid Red Flags |
| :covidremind | Covid Reminder To Social Distance, Wash Hands, etc |
| :covidtest | Recommend Covid Test |
| :cthead | Canadian CT Head Rule |
| :date | Current Date |
| :depain | Digital (Video) Exam for Pain |
| :demental | Digital (Video) Exam for Mental Status |
| :depeds | Digital (Video) Exam for Pediatrics |
| :deresp | Digital (Video) Exam for Respiratory |
| :deabdo | Digital (Video) Exam for Abdomen |
| :eczemamgt | Eczema care instructions |
| :finish | Finish to visit note (results, prescription, etc) |
| :findfp | Recommendation to find family physician |
| :FIFE | Feelings, Ideas, Function, Expectations |
| :fufp | Follow-up with your regular Family Physician |
| :fuwr | Follow-up when results are available |
| :gad7 | GAD-7 questionnaire for anxiety |
| :gcs | Glasgow Coma Scale |
| :giredflag | Gastrointestinal Red Flags |
| :headachefu | Headache Follow-up Precautions |
| :headacheredflag | Headache Red Flags |
| :hitsh | Hypothyroid Symptoms |
| :ibsmgt | IBS management suggestions |
| :ironho | Handout on Iron in Foods |
| :ksprevent | Strategies to Prevent Kidney Stones |
| :life | General lifestyle advice |
| :lmom | Left message for patient |
| :lotsh | Hyperthyroid Symptoms |
| :lowtestinfo | Low Testosterone Related Info |
| :menses | Menstrual History |
| :mse | Mental Status Exam |
| :neuroexam | General Neurology Exam |
| :neuroredflag | Neurology Red Flags |
| :noother | No allergies, meds, med issues, etc |
| :OLDCARTS | Pain History Acronym |
| :opsredflag | Subjective Ophtho Red Flags |
| :oporedflag | Objective Ophtho Red Flags |
| :pain | Pain History |
| :perc | PERC criteria to rule out PE |
| :phq9 | PHQ-9 questionnaire for depression |
| :physio | recommendation for physiotherapy |
| :preprisk | Pre-Exposure Prophylaxis (PrEP) for HIV Risk Score |
| :psylink | Useful psychiatry links |
| :psylinkbc | Useful psychiatry links specific to British Columbia |
| :psymed | General advice about antidepressants |
| :PQRST | Pain History Acronym |
| :refer | Referral sent |
| :results | Explanation of results follow-up |
| :rice | Rest Ice Compression Elevation advice |
| :risksuicide | Risk factors for suicide |
| :rxchiro | Prescription for Chiropractor Treatment |
| :rxcompression | Prescription for Compression Stockings |
| :rxget | Instructions for completing prescription |
| :rxkeflex | Prescription for Cephalexin (Keflex) |
| :rxmassage | Prescription for Massage Therapy |
| :rxmastitis | Prescription for Topical Treatment for Mastitis |
| :rxorthotics | Prescription for Custom Orthotics |
| :rxphysio | Prescription for Physiotherapy |
| :sessri | Side effects of SSRIs |
| :sleephy | Sleep Hygiene |
| :snet | General safety net advice |
| :snet2 | Safety net advice while waiting for results |
| :SOCRATES | Pain History Acronym |
| :stitest | Recommendation for STI testing |
| :strepscore | Strep Throat Score (McIsaac) |
| :sxetohwd | Symptoms of ETOH withdrawal |
| :sxgad | Symptoms of Generalized Anxiety |
| :sxmania | Symptoms of Mania |
| :sxmdd | Symptoms of Depression |
| :sxpanic | Symptoms of Panic Attack |
| :time | Current Time |
| :tremorinfo | Tremor Related Info |
| :wellsdvt | Wells Score for DVT |
| :wellspe | Wells Score for PE |
| :xray | X-ray being ordered |
| Clinical Notes | Description |
|---|---|
| :abdopain | Abdominal Pain |
| :ankle | Ankle Pain |
| :aub | Abnormal Uterine Bleeding |
| :back | Back Pain |
| :bellsp | Bell's Palsy |
| :canker | Canker (Aphthous Ulcer) |
| :chestpain | Chest pain |
| :covidmonitor | Covid Monitoring |
| :covidphone | Covid Related Phone Call |
| :covidrisk | Covid Risk Assessment |
| :delayedejac | Delayed Ejaculation |
| :depression | Depression |
| :driver | Driver's Medical |
| :excision | Skin excision |
| :fatigue | Fatigue |
| :ffertility | Female infertility |
| :fluvac | Influenza vaccine visit |
| :gout | Gout |
| :hairloss | Hair Loss |
| :headache | Headache |
| :hernia | Hernia |
| :hsv | Herpes Simplex Virus |
| :ibs | Irritable Bowel Syndrome |
| :injcort | Injection of Corticosteroid |
| :insomnia | Insomnia |
| :intro | Introductory Visit |
| :lowtest | Low Testosterone |
| :nailfungus | Nail Fungus |
| :noshow | No show note |
| :nosebleed | Epistaxis |
| :ocp | Oral Contraceptive Refill |
| :phone | Basic phone call |
| :redeye | Red eye |
| :refill | Refill medication |
| :refills | Multiple refills for medication |
| :shingles | Shingles rash |
| :sicknote | Sick Note |
| :skininfection | Skin infection |
| :SOAP | Basic SOAP note |
| :sti | STI concern |
| :stye | Hordeolum (Stye) |
| :strep | Strep Throat |
| :strepphone | Strep Throat Positive Phonecall |
| :tremor | Tremor |
| :urti | Upper Respiratory Tract Infection |
| :uti | Urine Tract Infection |
| :uti2 | Urine Tract Infection (alternate) |
| :vertigo | Vertigo |
| :wrist | Wrist Pain |
If you are interested in becoming a contributor contact me by email
medical-docs was created by Bill Ressl and is licensed under the GPL-3.0 license. If you decide to use the contents outside of espanso, contact me by email
The contents of this package is intended only for use by licensed medical professionals as a tool that may be helpful in their work. It is provided "as-is" without any guarantee of correctness or completeness. In particular, it should not be used to diagnose or treat any illness.