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Introduction to Clinical Notes: Charts, Images, X-Rays and Attachments
Introduction to Clinical Notes: Charts, Images, X-Rays and Attachments
Steven avatar
Written by Steven
Updated over a week ago

In this article, we will discuss how to use Chart type notes, make annotations on inserted images, explore the X-Ray tab and insert an attachment directly linked to a clinical note.


Front Desk allows you to incorporate any image of your choosing into your clinical notes as seen in the previous article in this series. For practitioners who do not necessarily need to add text information to a note, a Chart Type note removes the word processor components and allows you to interact with Charting tools.

Create a Chart Type Clinical Note from the System menu > Clinical Notes Templates as per the previous article. When you select a Chart type note, all you need to do is browse for the image file on your computer and give the template a name.

The word processor components are removed and replaced with the Charting tools at the bottom of the screen.

From Left to Right these tools are:

- Draw Freehand: allows you to use your mouse to draw markings on the image in real time

- Draw Line: allows you to easily draw straight lines, click and drag out with the mouse to draw a line

- Draw Text: allows you to insert a text box and add typed text to your chart

- Select: allows you to select inserted elements to move them around or remove them

- Delete: allows you to delete elements selected with the Select tool. Note that you can also use the Delete key on your keyboard to replicate this function.

- Stamp Icons: a series of buttons which allow you to make quick annotations to your chart using the displayed symbols.

- Auto Fit: fits the chart to the viewing area, click again to view at original size.

- Colour Panel: to the left you will see the active colour, any drawings or stamps used will be visible in this colour. Next to it is the Font options button, followed by the custom colour picker. Finally, you have access to some quick colour buttons which will instantly change your active colour.

Images in Clinical Notes

Whenever you see an image in a clinical note, you can simply double click on it to bring up the editing tools found in chart type notes.

When you do this, you will notice that the same tools appear, however on the left instead of the bottom.

You can use these tools in different combinations to paint over your chart however you need to.

X-Rays, Images and Attachments

Front Desk allows you to scan in or add images to be easily accessible under the X-Rays tab of a patient’s file. The X-Rays tab can also be renamed to Image, Photo or Scan by going to the Options tab of System Information and using the drop down.

By Default, the X-Rays tab will appear at the end of a patient’s file, next to Clinical Notes and will also open full screen for convenience.

To insert an existing X-ray image, click the Add X-ray button. Locate and select the image you wish to insert then click Open. To select multiple X-rays, hold down the key on the keyboard whilst making your selection. You can import images in colour by selecting the Include Colour when Importing (Default Greyscale Only) option.

X-rays can be scanned directly into the X-rays section of a patient file. This functionality is reliant on an X-ray digitiser or scanner being installed and working on your computer prior to scanning X-rays in Front Desk 2016. Click Scan X-ray to open the scanning dialog.

To create an X-ray report, click Add Report. Enter a title, the date and the report details. Click OK to save.

To associate a report with a particular X-ray, select the X-ray then click Edit. From the drop-down box select the report you wish to link to the X-ray and click OK.

Select an X-Ray and click Detail at the top, or double click the X-Ray to view in greater detail.

While viewing an X-Ray full screen, you have the following buttons available on the left:

On the right:

The Print button will print the selected X-ray.
The Export button allows you to save the X-ray in another location.
The Invert button reverses the X-ray.
The Rotate button turns the X-ray 90° clockwise.
The Swap button switches the position of the X-rays from left to right. This option is only when two X-rays are displayed.

button displays just one X-ray on the screen.

button displays two X-rays on the screen.

button displays the X-ray report attached to that X-ray. While viewing the report, you can also edit it from this screen directly.

The below X-Ray example has an angle and ruler applied.

You can create X-ray folders to logically organise a series of X-rays and reports into folders.

To create an X-ray folder, select the Add Folder button. Enter a Description and click OK to save.

To add x-rays or reports either drag and drop onto the folder or double click on the folder and add accordingly.

To close the folder, double click on the folder containing the green up-arrow to the left.

On the Clinical Notes tab, you can access X-Rays and reports by using the Show X-Ray thumbnails icon highlight below. From here, double click an X-Ray or report to bring it up on screen.

Front Desk also allows you to add an attachment to a clinical note by using the Attach button on the right. Find the file on your computer and select OK to attach it.

You will now see a paperclip appear next to the Clinical Note in the list and the file itself just above the Clinical Note, similar to the way an attachment would be displayed in an email. Simply double click the file to open.

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