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Adding annotations to patient documents

Annotate PDFs and image files

Updated over a week ago

You can annotate PDFs and image files (PNG, JPEG/JPG, TIFF/TIF) from the Inbox, from the Patient Files section of a patient chart, and when attaching a document to an encounter. This makes it easier to add notes, highlight important information, and collaborate with colleagues.

For example, when you receive a prescription refill request from a pharmacy, you can quickly add text and a signature to the document from your inbox and send it back to the pharmacy immediately.

📌 Notes: You can only annotate documents that are assigned to a patient.

Steps

1. From the main menu click Inbox or, from the patient chart, click Start/Open > Patient Files.

2. Find and open a PDF document or image file, and click the Annotations icon.

📌Note: If you open the document from the inbox, you must assign the document to a patient before you can annotate it.

📌Note: If you view the PDF in a large window, the pencil icon might not be visible and instead you see the annotation tools immediately.

3. Use the following options in the PDF annotation section that appears:

Icon

Description

Text

To type text anywhere in your document, use the text box feature.

1. Click the Text icon.

2. Use the formatting bar that appears to select the colour, font, size, opacity and alignment for the text.

3. To add the text box and type, click anywhere in the document

4. To delete the text box, select it, and click the trash bin icon in the formatting bar (or press delete on your keyboard) and confirm the action.

Signature

1. To add your signature, with today's date below it as a separate element, click the Signature icon.

The logged-in user's signature appears at the bottom of the current page they are annotating.

📌Note: If you do not have a signature configured, refer to Configuring signatures.

2. To change the position, click, drag and drop the signature or date to a suitable area.

3. To edit the signature, click it to:

  • Resize

  • Rotate it

  • Adjust the opacity

4. To edit the date, click it and use the formatting bar that appears to select the colour, font, size, opacity and alignment for the text.

📌Note: You edit the date and signature separately.

⚠️ Important: When you add a signature to a fillable PDF, and close the document, you can no longer edit the fillable fields.

Drawing

1. Click the expanding arrow beside the Drawing icon to select the following modes:

  • Drawing

  • Freeform Highlight (highlight any area of the PDF with a free hand)

  • Text Highlighter (highlight text only)

  • Eraser
    📌Note:
    This only removes the Drawing and Freeform Highlight annotations.

2. To select the colour, opacity, and thickness, use the formatting bar that appears.

3. To draw, highlight, or erase, click and drag the cursor

4. To finish your drawing, double click outside the document or click Save changes

Arrow

1. To draw an arrow or rectangle, click the expanding arrow beside the Arrow icon to select:

  • Arrow

  • Rectangle

2. To select the colour, opacity, thickness, and type of line, use the formatting bar that appears.

3. To change the position, click, drag and drop the shape to a suitable area.

📌 Note: When adding Text, Arrow and Rectangle annotations, you only need to select the annotation tool once to use it consecutively. The tool remains selected until you choose another tool.

4. To underline or strikethrough text,
a. With your cursor, highlight your chosen text
b. From the toolbar that appears, select the underline or strikethrough annotation.

5. To save annotations, on the right of the banner, click Save changes.

📌Note: As you add annotations, a banner appears above the formatting bar indicating that your changes are saved every ten seconds if your cursor is over the document. As soon as you leave the document, the auto-save countdown stops.

6. To edit text, the date under your signature, drawings, arrows or rectangles, click the item and use the formatting bar that appears below the annotation tools. You can change the colour, size and opacity of the selected annotation.

7. To move an annotation after you added it, click it and drag and drop it to the desired location.

8. To delete an annotation after you added it, click it and select the trash bin icon in the formatting bar (or hit delete on your keyboard) and confirm the action.

📌 Note: After you close the document, you cannot edit the annotations.

9. To return to the inbox, click X or Close.

⚠️ Important: When you add a signature to a fillable PDF, and you close the document, you can no longer edit the fillable fields.

The latest version with annotations is displayed in the Inbox and the Patient Files section of the patient chart. To locate the original version of the document without annotations, or older versions with annotations or edits, go to the Patient Files section of the patient chart and view the document’s history. Refer to Viewing and modifying patient files.

After you edit a document that is attached to an encounter, all versions of that document are saved in the encounter and the Patient Files section, with the latest version listed at the top.

If you open an older version, a red warning banner at the top of the document indicates a newer version available. To view that newer version click a newer revision.

Updated May 30, 2024

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