About Text Editing

During the deficiency completion process, you may encounter a document that you can text edit. This capability is especially helpful when a transcribed document (such as a Consult, History and Physical, or Discharge Summary) must be reviewed and signed by the dictating physician. Each physican must be given security permission for the document editing function. There is no limit to the amount of text you can add, update, or delete. (Many of your documents with deficiencies will just require reviewing and signing without editing text.)

The following topics provide valuable information about understanding and using text editing:

What is an editable document?

To be an editable document in the module, the document must:

Be text-based (introduced into the system by way of an electronic interface typically through a COLD feed, such as transcriptions); editing of HL7 documents is also supported
Have a signature deficiency associated with it
Be a document type defined as being editable (the document must be defined as editable before the deficiency is assigned)

If only one signature deficiency exists for the document, it cannot be text edited after it is authenticated (reviewed and signed). The document becomes text editable again when another signature deficiency is assigned to it. If the document has multiple signature deficiencies at the same time, it can be edited and signed by another physician.

Multiple signature deficiencies on a document

If a document contains more than one signature deficiency, each physician can edit and sign the document. The "Authenticated and edited by..." signature text cannot be edited.

When a document is edited and signed, any other signature deficiencies on it will be moved to the new (current) document. Annotations or overlay notes will remain with the original.

The deficiency is made inaccessible during the time that it is being edited and authenticated, as well as for the system processing time while the changes are being applied. This makes it temporarily unavailable to another physician in chart completion who has a signature deficiency on the document, or another member of the group processing deficiencies. System processing time includes:

Time spent by the physician who has the deficiency open while he/she views other documents or is processing the selected deficiencies. The document is not released until the deficiency is signed/completed or the physician clicks the Exit Viewer button to exit the viewer.
Time spent while the system is programatically affixing the edited text and signature to the document. When the Text Editing service performs this function, a new image is created with the added text. The new image is processed through Index Upload and must be re-released. The Signature service also rasters the signature to the document.

If you attempt to view a document for a deficiency while it is being processed, the system displays "All selected documents are currently locked for text editing."

Retain prior versions?

If your enterprise allows text editing, the system can be configured to preserve the original document, the current edited version, and any prior edited versions of it. Enable Versioning is an enterprise level parameter. If the parameter is disabled, only the current edited version is retained. If versioning is enabled, security permission is required to be able to access predecessor versions of a document. See About Document Versioning.

Rules for the restricted viewing period

Each editable document type can be configured with a restricted viewing time (this may be in days or hours). The purpose of this is to allow the physician assigned the deficiency a period of time to review and edit the document in completion mode before it is generally available to other system users (physicians of record, analysts) in Medical Record view mode. For example, you might have 12 hours to review and edit a History and Physical, or 24 hours for a Discharge Summary, depending on the bylaws of your institution. Editing is allowed in completion mode only.

Documents in "view restricted” status are indicated on the document tree by a 'clock' icon . The clock indicates that the document is editable, has a signature deficiency, and the time set to edit the document has not yet elapsed. If you select a document from the Medical Record view document tree, or access a document in Encounter view, and it is view-restricted, the system displays the following message: This document is restricted. You cannot view this document until it has been signed by the authenticating physician or the restricted period is expired. If you select multiple documents, the view restricted ones are not displayed.

You can always access the view restricted document provided you are assigned the signature deficiency associated with it (as an individual or as part of a group - unless the deficiency is being processed by the system). Users who do not fit into these categories will receive the above message and cannot see view restricted documents from the chart.

If the document is signed during the restricted viewing period, it again becomes viewable by anyone with permissions.

Other text editing considerations

If a document has its only signature deficiency removed, it is no longer editable.