Referral/Reply Letters (Patient Correspondence)

This chapter deals with letters written regarding a particular patient to somebody in the Address Book, typically a referral to a specialist or a letter back to a referring doctor. For the purposes of this chapter we will refer to them as referral letters.

Referral letters can be created by clicking on the button with a Quill icon from either the patient’s clinical window, the Appointments Book or the Patient's List.

Alternatively you can use a couple of different options in the Patients menu, which takes advantage of the Letters Dictated tickbox in the New Consult window. See the Patients Menu.

Clicking on this button brings up the Search window to allow you to search the Address Book.

Enter the first few letters of whichever field is appropriate, then click OK. You do not have to fill out every field, remember this is just a search...

If you require a blank letter just click OK without entering any search criteria.

Note: If you have already assigned a referring doctor to the patient, in the patient's demographics (see Edit Patient) then this window does not appear, and the letter is automatically addressed to the referring doctor.

If a matching record is found in the Address Book then a new letter will open using the Default Template.

Place your cursor in the body of the template and type your letter. Print or Save the letter as appropriate.

Button Description

The Default Letter drop down menu displays a list of different types of letter templates available, and allows you to add new templates. For example, GP's may want to have a standard referral template for a 5 yearly check colonoscopy. Once you have created the template you can select it from this list and just hit the Print button without having to do any typing at all. Or you may have three specialists, each of which has their preferred formatting of Referral/Reply letters, so in this instance you could select the Doctor's template from this popup menu. For more on adding new templates, please see, Adding New Templates.

The From popup menu allows you to choose the doctor from whom the letter is being written.

The names in the menu are those users who have the Show me in the Billing Menu checkbox in User Preferences ticked. If your name is already in this list then you will be selected automatically when the letter is opened. If a receptionist is typing the letter, then s/he needs to select the doctor before the letter can be saved.

The To field will be the heading of the letter, naturally it defaults to who the letter is addressed to but can be changed if required, without affecting the letter itself. Please note that this will not readdress the letter, you need to do this using the readdress icon (see below)

Prefers can be set in the addressee's Address Book entry. This is how the receiving doctor prefers to receive their letters.

The Send Via 3rd Party checkbox allows you to send the letter via Argus or Healthlink. For more information on this please see Electronic Correspondence.

The Reviewed checkbox would normally only be used by specialists where someone else is usually typing the letter. The doctor would tick this box after reviewing the letter to let the receptionist know that it was ready to send.

The Printed checkbox is automatically checked when the letter is either printed, faxed or emailed.

The Flagged for Followup checkbox is used for important referrals where you need to ensure that the patient actually attends the specialist. When a reply letter is received, you would then check the Reply Received Checkbox.

To see how these checkboxes are used in practice, see Reviewing Correspondence.

Can't Delete will not allow the letter to be deleted at all from the database once saved.

The Spellchecking checkbox provides an integrated spell checking facility into letter writer. To check spelling at the end of your document, select Tools > Spelling.

Learned words are stored in a dictionary file names Perso69632.dic located within your Genie folder. This is updated each time you Quit out of Genie.  If you wish to edit the dictionary you need to go to:

Windows Genie Solo: C:\Documents and Settings\All Users\Application Data\4D

Windows Genie Client: C:\Documents and Settings\<Windows Log in Name>\Application Data\4D

Macintosh: Library/Application Support/4D

In here will be a file named perso69632.dic or similar. Open this with Notepad or Textedit or similar. Make the required changes and save.

The Edit Template button will open the underlying template for this letter to allow you to make permanent changes to the letter, affecting all future letters, not just the one in view.

Convert to Text allows you to edit/format an inserted reference eg. an address without it highlighting and deleting the whole reference.

The Email button creates an email in Genie’s built-in email client, and places it in the Outbox. If you have entered an email address in the addressee’s record (in Open > Address Book), then the email will be sent the next time you send or receive email. When a letter is emailed, any images which have been inserted are automatically sent as attachments to the email.  For more detail on using Email in Genie, see Email.

Note: If you want your letters to keep their formatting when encrypted then select 'Send as RTF attachment' when prompted. This is provided the receiver can actually receive in RTF though.

The Labels buttons allow you to print sticky envelope labels for either the patient or the addressee. Genie’s built-in labels currently handle only A4 with 14 labels per sheet, or the Dymo Labelwriter series, or otherwise custom labels can be setup. For more information please see the Labels chapter.

The Envelope button allows you to print an envelope for the Addressee and/or the CC's.  When printing an envelope you have the  option to print the following: return address details, the patient's name and addressee's (or CC's) phone number, down the left hand side of the envelope.

Additionally you can choose the envelope size, on Window machines. On Macintosh machines this option does not appear as you can set your envelope size in the Printing Preferences (File > Printing Preferences) Page Setup button.

The Print button will print the letter, defaulting to the printer which you have selected in the 'Letters' option of File > Printing Preferences.

The Full Page button makes the 4D Write word processor open to full page to type if you wish. This also allows you to fax the letter using whatever fax software you have installed on your computer.

The Word button will open the letter in Microsoft Word. You must, of course, have Word already installed on your computer. This feature is for those people who prefer to use Word’s Autotype and AutoCorrect functions. Once you have finished writing the letter in Word, Save and Close the Word document and return to Genie.

Note: If would like to use this function it is recommended that you turn on the option to save letters reimported from Word as attachments in the General tab of your User Preferences (File > User Preferences).

You will notice that the Word button is now coloured red. Clicking again on this button will import the Word document back into 4D Write with all formatting retained. If the import is successful, the Word document is then automatically deleted from your hard disk. It is temporarily stored in a folder called “Letters” within the Genie folder.

Note: You must remember to close the Word document before attempting to import it back into Genie, otherwise it won’t work!

The Edit Doctor button opens the addressee’s record in the Address Book, allowing you to add or modify any of their details. e.g. Email Address.

The Re-Address button allows you to select a different addressee for the letter. This would most commonly be used where the letter has defaulted to the referring doctor, but you wish to send a letter to someone else about the patient.

Note: This button will only work when you initially open the letter. Once the letter has been saved, the references are “frozen”. In this case you would need to copy the contents of your letter, recreate a new letter, change the doctor and paste in the copied contents.

The CC button places a CC with address information at the bottom of the letter. You can CC anyone in the Address Book, and can have as many CC’s as you like. Holding down the Ctrl key will put the CC address in a window envelope format. Once a person has been a CC on a letter you have the option of marking them as an 'interested party'.

Interested parties can be accessed through the CC button or the Interested Parties button in the patient's clinical or demographic window. You can edit the list of Interested Parties through this icon or by selecting 'Edit Interested Parties' from the CC button.

The CC section appears once you add a CC and allows you to send your CC letters to their recipient via a third party if necessary. If you right click on the CC, you can edit their details or print envelopes/labels for them.

The Save button saves what you have already written without closing the window. This can be useful when writing a long letter in case you have a sudden crash.

Macros

Macros assist in your typing by expanding typed shortcuts to bigger blocks of text as programmed by you, a la Spellcatcher and As-U-Type.

The Macros are triggered by typing your shortcut followed by a Space or Carriage Return or by selecting the shortcut from the Macros menu.

This is also where they can be disabled if necessary and where new Macros can be added through Edit Macros... Or by highlighting what has been typed already and pressing Ctrl M. If you currently use Spellcatcher or As-U-Type you can import your existing macros, by selecting Edit Macros and clicking on the Import button. This will give you instructions on how to first export your existing macros from Spellcatcher and As-U-Type. You can then import this file.