Creating your own Differential Diagnosis SmartList in EPIC
Tutorial for EPIC SmartList (drop-down differential diagnosis menu)
Epic is INCREDIBLE - if you know how to use it.
A few weeks ago, I shared a sneak peek of my Epic setup on TikTok and it went my version of viral. Hundreds of people saved it, shared it, and asked for the tutorial, which is wild.
So here it finally is!
This is as step-by-step as I could make it. I'm working on a video of this, but in the meantime, hopefully this little tutorial helps.
*Please note: the Epic you have access to at your site might look a little different than mine, and the options you have available to you may be different. Please try this, and if you cannot find something similar, speak to your IT team and see if they can help you.
The process for my institution's version of Epic is as follows:
My Tools → My SmartPhrases → SmartList (left) → New User SmartList → add a name* → add display name (can be the same) → selection type: multiple → add your differential, one “symptom” per line → ACCEPT
Take a look at the video on TikTok to see how it should look.
*I recommend your initials + DDX (example: AFDDX)
Note down the NUMBER at the top of the screen in the brackets, you’ll need that number later.
Now, to actually use your SmartList, you have to add it to your template aka SmartPhrase. Click on “Manage SmartPhrases” - I personally included this drop-down into my basic template for all adult ED patients, so my "AFEDNOTE" template. This is a sample statement you can use:
Differential diagnosis includes but is not limited to, for {name:48256}.
The key phrase is {name:thenumberfromabove}.
When you're done, it should read like this: "Differential diagnosis includes but is not limited to, for fever: _ , _ , _ , _."
You can make your list of differentials using all kinds of online resources, or if you’re interested in my personal list, adapted for your use, you can get all 22 of the most commonly seen chief complaints here.
Quick note on my personal list of differential diagnosis considerations, shared above:
- It took me years to finally consolidate all my thoughts into one cohesive list, and I used my free time to adapt it to make it useful to my audience.
- I went back and forth about sharing it: I know many people have thoughts on the utility/validity of such lists, and some nasty comments were made online which I'm doing my best to ignore.
- I decided to make the tutorial completely free (above) so that you could use it to create your own dropdown, and I finally decided to make my DDx list available for $5, which I hope is low enough that it will feel worthwhile while keeping the trolls at bay.
I will update the product as more things pop into my head: if you purchase, you will receive a live link to a private Notion page, so edits I make will automatically appear. You are encouraged to adapt this list as you need: add things, take them out, make it your own. My DDx list is in no particular order, and there is some overlap (for instance, lower vs. upper abdominal pain has some crossover, and I often use elements of both for my “diffuse” abdominal pain considerations).
Additionally, keep in mind that the items in each list are also not in order of “severity” at all, and the list is not exhaustive. I tried to include many of the most common diagnoses and considerations we come across in emergency medicine, but this is not legal advice.
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I would like to emphasize that I am by no means a medicolegal expert, and this is a compilation of things I’ve learned in my 3+ years of training. On my blog, I wrote another blog post with resources about documentation and tidbits for residents/young attendings.
If you found that helpful, sign up to receive updates when new blog posts go live! I hope to share insights into residency life, transitioning to attendinghood and so much more.
Follow my journey on Instagram at @a.youngdoctors.journey with day-in-the-life contents & bittersweet moments from training and beyond.
