Patient Notes

 

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View a patient's appointment history, record clinical notes and access every part of their consultation from a single workspace.

 

 

 

Overview

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The Patient Notes screen is the central clinical workspace within Practice Master. It provides access to every appointment for the selected patient together with the clinical notes, diagrams, handouts, referrals, invoices and other information recorded during each visit.

When no consultation is open, the screen displays the patient's complete visit history. Opening an appointment loads the patient notes template used for that consultation and displays each of its tabs in the navigation panel, allowing you to move quickly between different sections of the consultation.

 

Common Tasks

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The following common tasks can help you get the most out of this screen:

 

Create notes for a consultation

1. Click the Create Notesicon to the left of an appointment in the Visit History list.
2. Double-click a template from the 'Patient Notes Template' selector that pops up.

 

Open a consultation

1. Double-click an appointment in the Visit History list, or
2. Click the Edit Patient Notes button beside the appointment.

 

Create a new appointment

1. Click New Appointment.
2. Select the appointment details.
3. Save the appointment.

 

Navigate between note tabs

1. Open a consultation.
2. Select any tab from the left-hand navigation.
3. The selected section of the patient notes will be displayed.

 

Complete a consultation

1. Review the consultation notes.
2. Click Complete.
3. The notes become read-only and future changes are recorded through the Amendments tab.
4. When completed the green bar on the side of the appointment on the calendar disappears as a visual queue the notes are finished.

 

Create a copy of a set of notes

1. Right-click the notes you want to copy and select Copy Notes - these are the source notes.
2. Right-click a Booked appointment and select Paste Notes Over - these are the target notes.

 

 

Screen Reference

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A detailed description of various screen elements:

 

Visit History List

Displays every appointment recorded for the selected patient together with the appointment date, time, invoice status, appointment status, summary, practitioner, notes template and service.

Double-clicking a visit opens the patient notes for that consultation.

 

Patient Notes Navigation

The navigation panel on the left changes depending on whether a consultation is open.

• Visit History List always returns to the appointment history.
• Open Patient Record provides quick access to the patient's record.
• When a consultation is open, every tab from the selected Patient Notes Template appears between these two fixed options.

These template tabs may contain standard question and answer pages or specialised tabs such as diagrams, handouts, prescriptions or other custom content.

 

Search

Filters the visit history by summary, appointment status, invoice status, service or notes template.

 

Visit Status Indicators

Icons displayed beside each appointment indicate important information including:

• Private notes.
• Completed notes.

 

Right-Click Menu

Right-clicking an appointment provides quick access to almost every task related to that consultation.

• Open Patient Notes - Opens the selected consultation.
• Patient Record - Opens the patient's record.
• Invoice This Appointment - Creates an invoice linked directly to the appointment.
• Copy Notes - Marks the selected consultation as the source for copying notes.
• Paste Notes Over - Replaces the notes in the selected consultation with the copied notes.
• Print/Preview Notes - Displays a printable version of the consultation.
• Accounting - Create appointment invoices, view appointment invoices, invoice the patient independently of the appointment or view every patient invoice.
• Appointment - Edit, move, rebook, duplicate or locate the appointment on the calendar.
• Appointment Status - Mark notes as completed, make them private, cancel the appointment or mark the patient as having not arrived.
• Documents - Create document templates or open the patient's Documents & Letters.
• Email - Compose emails, use templates or view correspondence.
• Send SMS - Send an SMS using the patient's recorded mobile number.
• Intake Form - Email the online intake form or open an existing submission.
• Referrals - Create referrals or view previous referrals.
• Delete Notes Only - Deletes the consultation notes while leaving the appointment intact.
• Delete Appointment and Notes - Removes both the appointment and all associated notes.

 

Completed Notes

Completed consultations become read-only to preserve the clinical record. Any subsequent changes should be recorded using the Amendments tab, maintaining a complete audit trail of the patient's history.

 

Private Notes

Private consultations are only visible to the practitioner who created them and administrators with the appropriate permissions.

 

New Appointment

Creates a new appointment for the current patient.

 

Save

Saves any changes made to the current consultation.

 

Complete

Marks the consultation as completed and finalises the clinical notes.

 

Side-by-Side

Opens the consultation in side-by-side mode, allowing multiple note tabs to be viewed simultaneously for easier comparison and data entry.

 

Close Note

Closes the currently open consultation and returns to the Visit History List.

 

Exit Notes

Closes the Patient Notes workspace and returns to the previous screen.