⭐️ Basic Custom Instructions

Placing parameters for Custom instructions helps Nabla adhere to your instructions more consistently. For example:

• Adding the word “Include” to start your instruction triggers Nabla to include the specific information you’re looking for into your generated note.

• Adding the words “as mentioned” at the end of your instruction lets Nabla know that you want this information generated into your note only if it is found in the transcript. You could also try “as explicitly mentioned” for an added layer to let Nabla know you only want this information pulled in when explicitly mentioned by the patient or provider during the encounter.

Below are examples of instructions to add to the General custom instructions field:

• Make note more concise

• Refer to patient as (insert the way you would like your patient referenced)

• My name is (insert your name) → This enables Nabla to refrain from using your name to address your patient

• Include maximum detail

Below are examples of instructions to add to different sections of your template:

• Include more detail regarding (insert specific information you wish to see captured) as mentioned

• Exclude information regarding (insert specific information you wish to be excluded in a section, i.e. Exclude information regarding past medical history in this section)

• Include ROS organized by organ system at the end of this section

• Include laterality of dominant hand and location of pain

• Include a paragraph titled "Health Maintenance" and include all health maintenance information as mentioned

• Start this section with patient’s name, age, gender, and reason for visit as mentioned

Adding your own PE/MSE/ROS exam as a custom instruction will ensure that Nabla pulls in the exam and captures the information needed to complete the exam findings.

Include and add information as mentioned:

PE:
Constitutional:
HEENT:
Lungs:
Heart:

Adding an ROS

Adding an ROS is as easy as entering the instruction below to the Subjective/HPI section of your chosen Nabla template:

Include ROS at the end of this section and add positive and negative symptoms as mentioned.

ROS:
General:
Skin:
HEENT:
Cardiovascular:
Respiratory:
Gastrointestinal:
Genitourinary:
Musculoskeletal:
Neurological:

Alternatively, for a shorter instruction, the below could also be utilized to bring in an ROS section at the end of your Subjective/HPI section:

Include ROS organized by organ system at the end of this section

Changing the title of a section to be something completely different than what the section is coded for, i.e. changing Subjective to Labs, will require a custom instruction directing information wanted to this section, which is where the word “only” comes into play.

Only include information regarding (insert information to be pulled into this section) as mentioned

By including the word “only” you are enabling Nabla to overwrite the information that would typically populate this section and bring in the information instructed.

Using the words “section” or “template” within a custom instruction are highly discouraged as Nabla knows these words in reference to the Nabla template and sections within.
An alternative instruction removing these words would be:

Include a paragraph at the end of this section titled “(insert title)” and include information regarding (insert information you wish to see captured in this paragraph) as mentioned

This will typically give the outcome of:

Title Chosen:
Information instructed to populate

This instruction helps to bring in a Past Medical History/Past Surgical History/Social History, etc. at the end of the Subjective/HPI section in Nabla templates that do not already utilize these sections, but can definitely be used throughout your Nabla template when needed.

The below custom instructions are geared more toward specialty providers who are looking for specific information associated with their specialty captured by Nabla.

General custom instructions field:

You are a cardiologist

HPI/Subjective:

Include cardiac symptoms, such as shortness of breath with or without exertion, lower extremity edema, elevated blood pressure, sudden left arm weakness and pain, when mentioned

Results/Labs:

Include information regarding cardiac labs, including cardiac enzymes, troponin, CK-MB, and cholesterol levels, when mentioned

Diagnostic studies:

Include information regarding cardiac diagnostic testing, including EKG, echocardiogram, stress test, Holter monitor, coronary calcium scan, cardiac MRI, transesophageal echocardiogram, when mentioned

General custom instructions field:

You are a (include specialty, i.e. Psychiatrist, Psychologist, Pediatrician, etc)

HPI/Subjective: (Pediatrics)

Include all details regarding sleep, bladder and bowel movements, grade level, daycare, school name, name of dentist and eye doctor with each on its own line if discussed.

HPI/Subjective: (Dentistry)

Include details of occlusion, overbite, overjet as mentioned

HPI/Subjective: (Surgery)

If surgery is discussed, include detailed information regarding all treatment options, including risks, benefits, and alternatives

HPI/Subjective: (Weight management)

If mentioned, include a detailed weight history with numbers and dates, details about nutrition, changes in weight, exercise, sleep, stress, mental health and response to medications. 

Use correct spelling for Saxenda, Wegovy, Ozempic, GLP-1, dietitian and Zepbound.

A&P/Assessment:

Problem headings should have a # at the beginning 

General custom instructions field:

Use medical terminology instead of layman’s terms