1. How do I maximize the use of the deployment diagram?
2. What do the brackets signify?
3. How do I use the SOAP note version for a new consultation or admission H&P?
4. How do I use the deployed version in a new patient?
5. A patient once told me that the reason he switched doctors was that the former physician kept getting the facts of his case mixed up (e.g., He asked the doctor why he was having Lt upper thoracic pain and the response was that it was related to the thoracotomy done for resection of his lung cancer two years previously when, actually, the patient had undergone primary radiation therapy and had not had surgery at all). How do I keep the facts of my patients straight?
6. Why choose Propinquity Software over another product?
7. Why not use template systems?

1. How do I maximize the use of the deployment diagram?
By using reverse pyramidal style or journalistic style as opposed to "novelistic" style, one assures that the essential database will likely fit into the Deployed version, as there is room for 200 characters (lower case). This allows for most level III notes to be included.

2. What do the brackets signify?
Information contained in the brackets is dispatched to the deployed version (up to 175 characters/box). Placing the closing bracket prior to 175 characters—say "close bracket" to your transcriptionist or voice recognition machine—will "hide" supplemental information from the deployed version. In either case, the SOAP version will look the same.


3. How do I use the SOAP note version for a new consultation or admission H&P?
Dictate the HISTORY OF PRESENT ILLNESS, SOCIAL HISTORY, FAMILY HISTORY in the Subjective, and click ROS to import the default negative ROS. Select and Edit the abnormal ROS. Then tab to the Objective, and click Physical Examination to import the default negative PE, and Edit in the usual manner. Tab to Assessment for Assessment data and Plan for Intervention or Plan of treatment.

4. How do I use the deployed version in a new patient?
As one goes through the available records or documents, and the patient-completed Family Social and Hospitalization Surgical & ROS Questionnaires, dictate the essential database with first the date of the document or event (one can choose 1/1/43 if only the year is known or under Subjective "Approximate Date"—frequently one will only enter Objective results, e.g., a CT/Abdomen report or a PSA value and skip the Subjective or Plan portions. Then one has an elegant Past Medical History which leads into the future deployed encounters as you continue to see the patient. The end result of having the Deployed Version is a database which can be printed and stapled to the H&P or consultation with the History portion being diminished to an expanded Chief Complaint. Much time is saved because the database has been memorialized in the Deployed version, and does not need to be recapitulated in the History portion. 

5. A patient once told me that the reason he switched doctors was that the former physician kept getting the facts of his case mixed up (e.g., He asked the doctor why he was having Lt upper thoracic pain and the response was that it was related to the thoracotomy done for resection of his lung cancer two years previously when, actually, the patient had undergone primary radiation therapy and had not had surgery at all). How do I keep the facts of my patients straight?
The deployment diagram is designed as a quick reference of all the essential database which is automatically deployed in a vertical chronologic format, facilitating quick review. It does not require extra dictation. Simply dictate each encounter with essential data initially, and supplemental information subsequently. This parsing of your SOAP encounter will come naturally after a little practice. Do not allow your practice to become memory-bound. Let the charting system do the work for you!

6. Why choose Propinquity Software over another product?
The Deployment Diagram and the Reverse Pyramidal style of dictation, which allows parsing of the SOAP database into essential and supplemental databases, is unique to Propinquity Software. All other systems demand additional dictation to achieve summary diagrams (if they even attempt to) because they employ novelistic style of dictation.

Template systems can become very disorienting as with any touch-screen system which flips you repeatedly between different screens and data fields. This distraction deflects one from the primary task of assimilating information, and doing clinical problem-solving rather than documentation-tasking. 


7. Why not use template systems?
They are quite disorienting because of the multiple screens one is constantly switching to. Voice Recognition systems allow more distraction-free composition of the database. Template systems often mix essential and supplemental information so that one can get quite lengthy notes which may impress an auditor, but then later on make it difficult to extract essential information in a chronic disease situation with multiple encounters.