Run a consultation

A consultation is the encounter record: the note you write, the orders you place, the results that come back, and the signature that closes it. Patients arrive in a consultation queue from triage.

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Before you start

Consultation has no care-area switch — it is always in the sidebar on Enterprise. Your hospital does need departments set up; with none, the module offers No Departments Found and a Set Up Departments button instead of a queue. See Departments. At a paid hospital, a patient’s consultation payment is used the moment a doctor opens and starts working the consultation — not earlier, at triage, and not by a nurse’s order alone. A visit the doctor never opens keeps its payment valid for whoever sees the patient next.

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What you’re looking at

The module opens on Select a Department — “Choose the department you’d like to access for consultations. Each department has specialized services tailored to patient needs.” Pick yours; if it has more than one sub-unit you choose that next, and with only one you go straight through. The queue that follows covers your clinic’s Queue window for consultations — 48 hours unless your hospital changed it under Settings → Facility → Queue windows (24 hours to 30 days) — and says so when it is empty: “No consultations found for Cardiology - Adult Clinic in the last 72 hours.” Nothing “moves” to history when the window passes: Consultation history holds every consultation, always, from the moment it exists. See Consultation history and Facility. The toolbar carries Search for patient, New Consultation, Refresh and View Columns. Columns are Patient ID, Patient Name, Status, Blood Pressure and Pulse Rate, with Doctor and Created At hidden by default. What a row offers depends on its status and on whether you may edit:

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Clicking a row, writing a follow-up note, starting another consultation

Selecting a row whose patient already has a consultation opens that consultation in update mode — never a new one. If someone else wrote it, the chart opens read-only under Written by their name, and you get Write follow-up note, New consultation and Admit patient instead of Update consultation; only the person who wrote a consultation can change what it says.

• Write follow-up note opens the same panel as in the chart: your own dated, signed entry under that consultation. From the row menu you do not have to open the chart first. The note appears under the consultation, in the chart’s Note tab, after you leave and come back.
• New consultation (in the row menu, and a button beside Admit patient in an open consultation) opens a blank consultation for the same visit. Nothing is created until you save it, so going back leaves no empty record. Once saved, that visit’s row opens the newest consultation; the earlier one is still in Consultation history. A draft you had started on one consultation is not offered on the other.
• In an open consultation you wrote, Follow-up note sits just before Dictate on the Note tab.
• A follow-up note can be corrected by the person who wrote it, their supervisor, or the co-signer of the consultation it sits under — nobody else, owners and managers included. They see a pen, Edit follow-up note, beside it. The edit panel is prefilled; the note stays signed by its author, and you tick I confirm this amendment is accurate and is my own edit. before Save edit is available.
• An edited note reads Written … · Edited … by your name, in your clinic’s time. Show earlier wording lists every wording it had before, with who wrote it and when, so nothing is lost.
• Each new consultation uses a consultation payment, as the first one did.

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What triage hands you

A row carries what triage already knows about the patient, directly under their name: their acuity level (coloured), a red Emergency badge if they were flagged one, and their chief complaint. Emergency patients sort to the top of the queue. Two more lines appear when they apply. Nurse orders — awaiting doctor means a nurse already placed a lab or imaging order at triage, which opened this consultation before any doctor took it — it is yours to review, not something already handled. ⚠ N open admissions is a warning, not a normal state: it means this patient has more than one ward admission open at once, and somebody should close the stale one.

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The chart

Beside the tabs, directly under Vitals at a glance, sits the From triage card: everything the nurse recorded in the triage Notes tab — chief complaint, category, arrival, consciousness, mobility, demeanour, skin, breathing notes and the triage note itself — plus who recorded it and when, and any labs or imaging ordered at triage, so none of it has to be asked for again. The card does not repeat the vitals, because Vitals at a glance is right above it. A Triage status block at the top of the card shows the early-warning score with its band (for example NEWS2 6 (medium)), any Isolation precautions and the Reassessment countdown, each only when the nurse recorded it; the acuity level, Emergency flag and Nurse orders — awaiting doctor sit in the card’s heading. There is no separate Triage card beside it. On a phone or tablet it appears under the vitals strip above the tabs. A long note starts shortened; select Show more to read all of it, and Show less to fold it back. If the nurse wrote nothing it says “No triage note was recorded.” If the nurse changes the note later, the card shows the new text and an Edited time. Nine tabs, always in this order: Overview, Chart, Results, Note, Orders, Vitals, History, Mail and Documents & forms. A new consultation lands on Note; viewing or updating one lands on Results.

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Guardians

Where a patient has a guardian recorded, a Guardians card appears in the chart’s left-hand rail. Each row gives the person’s name, a Primary badge where they are the primary guardian, and then their relationship and what they may see: A second list headed Guardian for shows people this patient is the guardian of. The two are never merged, because a mother is the guardian of a baby and not the reverse. A patient with nobody on file shows no card at all — that is silence, not a statement that they have no guardian. Where the lookup itself fails the card says Guardian links could not be checked for this patient. The card carries no phone number, email or address: a guardian is another person, and their contact details are not part of this patient’s clinical identity. Who pays is not shown here either. The card is read-only — it has no controls. The same card also appears on the patient’s own profile page, after their contacts. Both are set on the patient’s own record, on the guardian rows of the add and edit sheets: The header carries Back, Intakes, Upload, Check-in, Admit patient, Sign & lock (or Unlock) and the save button — which names what it will do: Create consultation, Save changes, or Save offline. A lifecycle badge reads Unsigned, Awaiting co-signature, Signed or Signed & locked. Your typing is saved as you go. The chip reads Saving draft…, then Draft saved — exactly what it is, a draft rather than a signed record — and Draft not saved — your note is still here if a save does not land.

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Write the note

The Note tab has two sub-tabs, Documentation and Diagnosis with a count beside it.

• Select Select template to insert a template. The popover searches as you type — “Search templates…” — and says “No template found.” when nothing matches.
• Dictate, with its violet microphone, opens the ambient note taker and turns a recording into structured note text.
• Anything AI wrote carries the banner “AI-generated — review before signing” and a Mark reviewed button.
• Use Collapse all and Expand all to move through a long template; a Filled badge marks the sections you have completed.

Diagnoses live here too, not under Orders. Select Add first diagnosis, then fill in Diagnosis description and “Clinical notes for this diagnosis…”. Add ICD-10 searches the code list, and there is a separate Clinical impression field — “Additional clinical notes or impression…”.

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Whose consultation is it?

The clinician who writes a consultation’s documentation is its author, and only the author can change it. Open a colleague’s consultation and it is read-only: a banner says Written by their name and the date, the Note editor and autosave are off, and the orders are read-only too. Owners and managers can read it, unlock it and countersign it, but cannot rewrite it. A consultation opened for the doctor by a triage nurse’s orders has no author yet. The first doctor to save documentation on it becomes its author, and that stays on the record. To add to someone else’s consultation — or to one that is already signed — select Add follow-up note. You write your own entry, sign it and it appears under the original on the Note tab, in Consultation history and in the exported PDF. The original is never edited. This is also how a doctor documents a patient who returns the same day: a follow-up note on that visit, dated and signed.

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Place orders

The Orders tab has four sub-tabs, each with a live count: Medications, Labs, Imaging and Services. Searching. Each picker searches as you type and puts the closest match first. Medications match on the product, generic or brand name, imaging and services also match on their codes, and a small typo still finds the item. Inactive medications and imaging tests aren’t offered. Prices. Every ordered item shows its price and each sub-tab shows a total. A lab test shows its panel price, or the price of each parameter when you ordered only some of them and each has its own price. Medications show a price per unit, because the quantity is decided at dispensing. An item your clinic hasn’t priced shows ”—” with No price set, and the total says how many items are unpriced. A clinic set up as free shows no prices at all. The same prices appear on the admission’s Orders tab. Urgency is an imaging control only. Orders go straight to the unit that fulfils them — the laboratory, radiology and pharmacy. Labs and Imaging show each test’s price as you add it, and a running total for each sub-tab — a lab panel priced by parameter shows every parameter’s own cost under it. Medications shows the unit price; the total is set once the pharmacy dispenses a quantity. A test or medication with no price configured shows “No price set” rather than a $0, so it never reads as free by mistake. None of this appears for a clinic marked free in Settings.

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Admit the patient

Select Admit patient to open the admission dialog. Once admitted the button reads Admitted and is disabled; everything else on the chart stays usable, so you can carry on documenting. Ward workflow continues in Admissions.

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Sign and lock

Select Sign & lock when the encounter is finished. A locked record can be reopened with Unlock, and the badge itself is the affordance — its tooltip reads “Unlock this note to edit it”.

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Working offline

Documentation keeps working without a connection: the save button changes to Save offline, and a save toasts Captured offline — “It will sync when you are back online.” An amber banner explains what is happening, and a running count appears while the queue drains. Three actions are deliberately switched off, each stating why. Sign & lock and co-signing say “Signing needs a connection”. Admit patient says “Admission needs a connection — a bed is a shared resource”, with the fuller reason in the banner: “two clinicians admitting offline would allocate the same one”. Everything you typed is still there when you reconnect. See Working offline.

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Who can do this

Anyone else opens the chart read-only with no message — no save button, no autosave chip, and every field disabled. That silence surprises people; if the chart will not take your typing, your role is the first thing to check. Two behaviours worth stating. Permission enforcement is opt-in per person: someone never saved in the permissions sheet is unrestricted, and the sheet warns “Saving starts enforcing”. And a denied action is recorded in the audit log while an allowed one is not — hiding a module in Role Navigation is a convenience, not a security boundary. See Permissions. A signed note is read-only for everyone, whatever their role, until it is unlocked.

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Check it worked

• The encounter shows as Completed in the queue.
• The lifecycle badge reads Signed & locked and the save button has gone.
• The counts on the Orders sub-tabs match what you entered, and each order is visible to the unit that must fulfil it.
• An admitted patient shows Admitted on the header and a bed on Admissions.

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Common issues

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FAQ