Write an effective prompt
A prompt tells Almanac what you want to know, create, or decide. It can be a question, an instruction, or a goal. Write naturally, review the response, then refine it with follow-up messages.
A short prompt is often enough. For larger or more consequential tasks, consider including:
- Goal: What should Almanac do?
- Context: Which patient, documents, or sources should it use?
- Output: What format, length, or level of detail do you need?
- Boundaries: What must remain unchanged? When should Almanac ask before continuing?
Include only what is useful for the task.
Describe the result you want
Begin with the outcome. Include the audience and format when they affect the answer. The same clinical question may require a different response for a resident covering nights, an attending preparing a protocol, or a patient reading a handout.
I'm covering an inpatient service tonight. What first-line changes should I consider for a patient admitted with acute decompensated HFrEF who is already taking maximal oral diuretics?
Describe the process when it matters. Otherwise, let Almanac decide how to search, compare, and approach the task.
Provide relevant context
Include details that could change the answer, such as age, comorbidities, current treatment, previous attempts, and your main concern.
A 64-year-old with compensated cirrhosis, Child-Pugh B, needs treatment for a UTI. Which antibiotics carry the clearest hepatotoxicity signal, and what would you use instead?
You can also:
- Attach documents you want Almanac to summarize, compare, or transform. See Files.
- Select a patient when the task concerns one person. Almanac loads the available records from your EHR. See Patients.
- Add documents you use regularly to your Library, then reference one by typing @.
- Ask Almanac to search when the answer depends on current evidence. Ask for sources when you plan to verify the result.
Specify where to look
When Almanac has access to several sources, name the one you want it to use and describe what it should find. You don't need to specify each search.
Using Literature Search only, find the trials supporting the current recommendation and tell me whether any contradict it.
Literature SearchType @ in the composer, then choose a plugin, tool, or file. Available plugins depend on what you have enabled and your organization's configuration. See Plugins.
Set clear boundaries
Tell Almanac what must remain unchanged and when it should ask before continuing. Boundaries are especially useful when the result will be shared or when an incorrect change would be difficult to reverse.
For example:
- Keep the doses and dates exactly as they appear in the chart.
- Use only the attached sources. Identify missing information instead of guessing.
- Prepare a draft. Don't send it.
- Leave the examination findings for me to complete.
One or two clear boundaries are usually enough.
Draft an email to the referring physician summarizing this visit. Show it to me before sending, and don't include the patient's date of birth.
Describe the output
Specify the format, length, and level of detail you want. Include what Almanac should leave out when it matters.
Compare the four options in a table with columns for mechanism, evidence quality, primary contraindication, and monthly cost. Don't include text before or after the table.
Ask for a final check
Almanac checks its work as it goes. For consequential tasks, tell it which checks matter most, such as confirming that each recommendation has a source, that the response agrees with the chart, and that anything it couldn't verify is clearly identified. Review the result before using it.
Make uncertainty visible
Almanac looks for gaps, weak evidence, and disagreements between sources as it works. When these distinctions matter to your decision, ask for them explicitly so they are easy to find in the response.
Where is the evidence weakest, and what would change your recommendation? Separate well-supported conclusions from extrapolation.
Dictate a prompt
Select the microphone in the composer, or press Control-Shift-D, then speak. Your words appear in the composer, where you can review or edit them before sending. See Voice.
Put the pieces together
For an important task, include the goal, relevant context, desired output, and any necessary boundaries. Ask for a final check when accuracy matters. You usually don't need to describe every step.
Prepare a one-page preoperative summary for this patient for tomorrow's list. Use the chart and the anaesthetic guideline in my Library. Begin with issues that could delay surgery, followed by medications to hold and when, then outstanding results. Keep doses and dates exactly as they appear in the chart. Use only those two sources, and identify anything you can't confirm. Before finishing, check each recommendation against the guideline.
Refine the result
Your first prompt doesn't need to include everything. Almanac keeps the conversation in context, so you can refine the response as you work.
Send a follow-up message
Instructions such as "Make it shorter," "Rewrite this for a patient," or "You missed the renal dosing" can stand on their own. You can add a source, correct the direction, or request another option without starting over.
Redirect Almanac while it works
Send another message while Almanac is working to apply the new instruction to the response in progress.
Explore another direction
Edit an earlier message and send it again. Almanac creates a new branch and preserves the original conversation.
Choose a reasoning effort
Use the reasoning control in the composer to choose how long Almanac works before responding. Choose a higher reasoning effort for differential diagnoses, conflicting evidence, and multistep analysis. Use a lower reasoning effort for quick lookups and rewrites. See Models.
Ask for a plan
For longer or consequential tasks, type / in the composer, then choose Plan mode. Almanac prepares a plan and waits for your approval before taking action.