If you need to send a patient's records to another provider or facility, you can do that via integrated efax, or by downloading the patient file and sharing it via a separate secure file sharing program (like Box.com).
Sending the Patient Record via eFax
Fax an Encounter Note
To fax an encounter note, open the note and go to Generate > Fax/Print Encounter Note. You will have the option to use check-boxes at the top of the generated form to:
- Add H & P - this adds blocks above the encounter note showing the patient's Allergies, PMH, list of SOAP/ Encounter notes on file, Active Medications, Need to Know Notes, Social Notes, and Insurance Information. Each of these may be removed individually by clicking the -Remove text at its right.
- Add cover page - this adds an editable cover sheet before the encounter note. Click in the message area to add your message, and click the green Apply button to save your changes.
- Include attached document(s) - if there are any documents attached to the encounter note, you can include them with the encounter note when faxing by checking the applicable box(es).
Fax Entire Patient Chart
To fax the entire patient chart, go to the main patient chart view, go to Generate > Printable Patient Chart. This creates a printable/ saveable/ faxable version of the patient's entire chart, omitting the patient's documents (more on how to send patient documents below).
Each section of the patient's chart has a -Remove button at the upper right to remove that entire section from the form. Or you can click on any of the sections to edit the information contained in that section, then click Apply to save your edits.
When you're ready, click the applicable button at the top to Print, Send as Fax, and/or Save as a document to the patient's chart. The Save option is useful for being able to share the entire record with the patient on the Patient Portal, if desired, OR for being able to send ONE fax with the patient chart plus patient's documents - see below for more info.
Fax Patient's Documents
To fax a document from the patient's chart, right click on the document title in the Documents block at the bottom of the patient main chart view and select Fax this Document. If you have saved the "Printable Patient Chart," you can use this method to fax the chart along with additional document(s).
This brings up a cover page in a new tab, and shows above the page any documents that are attached in a green bar at the top, as well as automatically as part of the body of the cover sheet. Use the "Attach Additional Documents" drop down at the top to attach additional documents from the patient's chart.
Then click on the message area to add/ edit the message in the cover sheet and click Apply to save your changes. Then click the button at the top of the page to Print or Fax your document(s) and cover sheet.
IMPORTANT NOTE ON FAX ERRORS & DELIVERABILITY: the larger the document becomes, the more issues you are likely to have with fax deliverability. For faxes above about 30 pages, your fax error rate will start increasing sharply. 50 pages is about the maximum, though errors are likely to happen at a high rate as you approach that maximum. To reduce frustration and error when faxing close to or above the maximum, you will want to break your fax up into 30-40 page faxes. OR, you can try downloading the patient file as a package (see below) that you can share via a secure external file sharing service.
Download Patient File as Package
Note: this option is available on all builds, or for all permission profiles. If you have sufficient permissions (under Admin > Manage > Users - Superadmin and Regular Clinical and Admin Staff permission profiles can access this feature) and do not see the option, contact firstname.lastname@example.org to enable this for you.
For builds that have this option enabled, you can download the patient's chart as a zip file - which includes all of the patient's documents, as well as an electronic printable version of the entire patient's chart - under My Links > Export Patient as Package.
Once you download the file, you can share it with the person you are sending it to via a secure file sharing service, like box.com, or the secure service of your choice. Note: because the downloaded file contains PHI, you will want to be very careful in terms of how you handle that data. You should avoid storing PHI on any unencrypted removable drive (e.g., a regular USB thumb drive), and will want to delete it permanently from your hard drive once you are done sending it.
The downloaded patient record is nested inside several folders. For examples:
- var > www > exports > pts_1_181210085413 > doe_john__11-20-1981_1
To access the patient's files, the recipient will open the enclosing folders until they see a document called overview.html, and folders for documents, images, and thumbs. The overview.php file is the patient's chart, including encounter notes. Patient documents are in the documents folder.