Writing letters and referrals

You can write letters and referrals from a patient's clinical record. You can also write letters from Documents and Results button Documents and Results or from File > Documents.

Letter templates are created by users with Reference Tables rights in Tools > Communicare Templates.

If you want to provide patient-specific information in a letter or referral, create it from the clinical record: click Letter button Letter. Encounter place and mode, patient details, and provider details are filled in automatically.

Alternatively, create a blank letter using one of the following methods:

Select File > Documents > Write New Letter
Select File > Documents > Browse Documents, and on the Outgoing Documents tab, click Write a new letter
Click Documents and Results and on the Outgoing Documents tab, click Write a new letter

Note: From Documents and Results button

Documents and Results, ensure you specify the place mode, patient and provider if they are not already specified, before using a blank template or any of the data objects.

To write a referral or letter about a patient:

In the patient's clinical record, click Letter.
In the Select Document Template window, select a letter template in the list and click Select. For example, select Antenatal Care Record for a referral, select Referral Letter (Standard).
Encounter place and mode, patient details, and provider details are filled in automatically, except if you use the blank letter template.
If you selected a referral template, in the Address Book, select an addressee.
Compose or edit the letter or referral:
- To insert links to web pages, documents, images and local network folder shares to tie patient documents to other resources, click or select Insert > Hyperlink.
  Note: Communicare will try to open the hyperlink target using the default viewing application. If a default application does not exist, choose the best program with which to open the link target from the Open With window.
- To insert images, click Picture or select Insert > Picture. Communicare supports the following image file types in letters: JPEG (*.jpeg), Windows Bitmap (*.bmp), Icon files (*.ico), Windows Metafiles (*.emf;*.wmf), and GIF (*.gif).
- To spell check the letter, click .
Add patient-specific information from the right-hand pane:
- Either double-click or drag an item onto the letter.
- To insert clinical information, expand Clinical Record and select the required item. For example, to insert the latest BP into the Antenatal Care Record:
  1. With the cursor in the BP field, select Clinical Record > Latest Qualifier (Value only).
  2. In the Qualifier Type window, in the Locate field, enter BP.
  3. Select BP - Diastolic Blood Pressure and click Select. The most recent value is inserted into the letter.
  4. Repeat steps a-c for BP - Systolic Blood Pressure.
- Some items will prompt you for information, such as:
  - Clinical Record > Investigation Results - select CTRL+click to select multiple results
  - Clinical Record > Progress Notes - select and preview one note at a time
- To insert drawings attached to a clinical item:
  1. Select Clinical Record and double-click Latest Qualifier.
  2. In the Qualifier Type window, in the Locate field, enter a drawing qualifier, for example Drawing:body (front and back).
    The drawing and a key including annotations are added to the letter. For more information about drawings, see Add drawings to clinical items.
From the Topic field, select an appropriate topic. Documents are filed with a Class type of Document and can be found under the Topic tab that you select.
In the Comment field, enter a useful comment. You can later use the comment to search for a specific letter without having to open each letter in turn.
Either print the letter or send it electronically, or both:
- To print the letter only, click Print and Save.
- To send the letter electronically only:
  1. Select an addressee if you have not already: in the Outgoing pane, double-click in the To field and select an addressee.
  2. Click Send Secure.
- To print the letter and leave the window open to also send electronically:
  1. Check the layout, click Print Preview.
  2. Click Print.
Click Save.

Letters and referrals are sent securely as PDFs when CCareQueue_SMD next runs. Outgoing documents are saved to C:\CCare\Communicare\out_doc and are displayed on Documents and Results button Documents and Results > Outgoing Documents tab.

Saved letters are printed to PDF.

If you entered a useful topic and comment, the letter can be easily retrieved from the Detail tab of the clinical record. Documents have a Class type of Document and can be found under the Topic tab that you specified.

Tip: If you are sending the letter or referral using PDS and the recipient cannot receive the document you attempted to send, you will see one of the following errors:

Table 1. Errors displayed if recipient cannot receive the letter or referral
Action	Error if recipient cannot receive the message
Create a referral and send as a letter	`The selected recipient cannot receive this document type`
Create a referral and send as eReferral	`Communicare cannot send CDA eReferrals via secure messaging`

If you later open a document from the Details tab in the clinical record, you are prompted with several choices:

Incoming documents will always open in read-only with no prompt.
For other read only documents, either:
- View the document as it is without being able to change the data in it.
- Create a copy of the document with the same data that you can edit. The old document will not be overwritten or lost.
For editable documents:
- View the existing document - this will open the document but not allow any changes to be made.
- Modify the existing document as it is.
- Create a copy of the document with the same information in it that you can edit. The old document will not be overwritten or lost.