Big improvements to treatment note autosaving

We have completely rewritten the treatment note autosave feature.  it is now MUCH better!   These will be quite comprehensive release notes as it's a change from existing behaviour, we don't like to do that often and want to make sure you understand the change.

How it previously worked

Previously as you started typing a new note we would automatically create a draft for you with the autosave.  We would then periodically save your progress so that if anything went wrong you still had the draft available.  There were a few problems with this:

  • If you started on a note and decided you no longer wanted it, you now have to delete the draft.
  • If your internet drops out while writing a note, the autosave won't help as it saved it to Cliniko so required you to be online still.
  • It was slow, so it could sometimes hold you up from saving your treatment note immediately when you were ready to do so.

How it works now

We no longer create a draft for you, but we do keep saving your progress so nothing is lost.  We now do our auto-saving to your computer (you won't actually see it, we sneakily hide it in your browser files).  If you ever lose a treatment note now, next time you go back to treatment notes there will be an option to recover your old one.

The benefits of this new way are:
  • We save instantly every time you type, so it will be completely up to date if you ever need to recover a note.
  • The autosave no longer requires an internet connection, so this will work even if your internet drops out (you do still need internet to begin typing the note).
  • No more drafts you don't want.
  • It's faster and it won't hold you up when saving.

Some examples

Creating a new treatment note

  1. You start creating a new treatment note.
  2. You forget to save it and move back to the appointments page.
  3. You go back to the patient later and your treatment note isn't there.
  4. You create a new one again and Cliniko will prompt you to recover your old note.
  5. You save it and you are happy.

Editing a draft treatment note

  1. You are editing a draft treatment note
  2. Your internet drops out and you cannot save
  3. You come back later and the draft note doesn't have your changes
  4. You edit the note again and Cliniko will prompt you to recover your old changes
  5. You recover them, save it and you are happy.

Demonstration of the new note recovery


 

Security Note: Even though the treatment notes are temporarily saved to your computer for recovery, we encrypt them so that they are still completely secure.

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Comments

  • Avatar
    Tyraus Farrelly

    Hi Guys,

    Don't know if I did something wrong but just lost the whole assessment note on new patient.

    Got out of treatment note, created invoice and printed, went back into notes to find no draft, (as explained above).  Didn't give option initially to restore so thought I had to click within the new treatment note.  This didn't work so went out of treatment notes than back in and got restore notice.  Unfortunately restored blank note, (I think) or just didn't work!

    This is an issue if you can loose your notes so easily!

    Tyraus.

    P.S  Have tried several times to recover, appears I have lost the whole assessment.

  • Avatar
    Joel Friedlaender

    @Tyraus, we'll look into it.  Thanks for the detail.

  • Avatar
    Tyraus Farrelly

    OK just figured out problem.

    If you have a list of treatment note templates, you need to select the specific template type you originally used, then the restore option will pop-up.

    I think I may have inadvertently made a blank note in the default template that shows when you first go to add a note and just kept restoring this blank note.

     

    Tyraus

  • Avatar
    felix ladyzhenskii

    Hi Joel,

     

    I relied on autosave extensively, as I would start notes for patients during the consult, and not come back to them till later/evening. Now I dont know which patients I have unfinished notes for??? Normally I would go to dash board, and work from the list on the right. After a full day of patients, you cant remember which ones have unfinished notes, we really need some feature for that....

     

    Felix

  • Avatar
    Joel Friedlaender

    Hi Felix, the autosave is really there as a fallback for if something fails, you forget to save, or now internet drops out.  So you know what notes you have to do, you should save as draft with the button at the bottom of the note.  That will do just what you were used to before, and it's much more reliable.

  • Avatar
    Joel Friedlaender

    Just an update here.  We had a couple of issues with this update.

    1. It was causing typing treatment notes to be very slow for some people using tablet devices.  We believe this has now been fixed, please let us know if you still have any trouble with this.
    2. Some people were getting logged out after saving a treatment note.  Again we have now fixed this and please let us know if it happens for you.

    I know this change is a bit different to how it worked before and we appreciate your patience in adjusting.

  • Avatar
    Claire O'Faircheallaigh

    Hi Joel,

    Our clinic agrees with Felix, I enjoyed being able to move between patients rapidly knowing that incomplete notes would be saved as a draft and be sent to my to do list on dashboard. Now there is no automatic record. I appreciate that if I push "save as draft" this would solve the problem but in a busy clinic that is one more step which I haven't had to do previously. Perhaps the drafts could still be generated if you leave the notes screen in the same format as before so you were still alerted.. I have no problems deleting unnecessarily generated drafts but am far more concerned about incomplete notes as a physio and a business owner.

    Scott

    (Practice Owner)

  • Avatar
    Tyraus Farrelly

    Hi Joel,

    I have to agree with others who have commented.  While I have been trying to adjust to the new system, for me it becomes confusing without the auto save to draft function and hinders quickly changing between screens.  I use two computers during the day so this further adds to the issue as it will only give restore option on pc the note was written on. Depending on which room I'm in will depend on the pc I use so at the end of the day I've got to go through both pc's to restore notes.  This leads to sometimes writing new notes for patients I have already written but not saved on other pc.  Restore also seems to take fairly long, especially when doing it a number of times at the end of day, when your busy this just all adds to increased time and work at the end of the day. 

    I have to say, I thought the old system was much more user friendly!

    Cheers, Tyraus

  • Avatar
    Claire O'Faircheallaigh

    I also work off two computers so have the same problem.

     

    Scott

  • Avatar
    Luke MHC

    Hi Joel,

     

    I and all my staff agree with Felix.  It is really hard to track and manage now especially when I am monitoring 8 other practitioners and ensuring their notes are typed up on time.  Dashboard was amazing as it would show how many notes I needed to finalise that day.  Now I have to go into every patients file, click on treatment notes, click on create note and then click on autosave.  It has made the whole process a lot more time consuming and in all honesty a massive pain in the bottom.  Can you restore it to what it was or create a link in settings whereby you can choose to return to the old way.  This new way does not work for us at all.

  • Avatar
    Joel Friedlaender

    @luke (and others).   Cliniko should still be working the same for you.  Whenever you create a treatment note, just press "save as draft" at the bottom when done and it will appear on your dashboard like you are used to.  

    Really we expected that to be the way people would do it anyway even with the autosave.  It wasn't designed (and still isn't) as a replacement for saving, it's there for if something goes wrong (internet drops out or you forget) and need to recover it.  The autosave/recover is something that should be used very rarely and shouldn't impact your day to day activities.

    I can obviously see that isn't how it was being used, and people haven't been pressing the saving as draft option at the bottom.  I am still confident that this is the best way for Cliniko to be moving forward, but it will take a little adjusting until saving as draft becomes habit.

    I am not turning a blind eye to this, I really appreciate all the candid feedback (in fact not just appreciate, I love to hear it).  It would be great though if you could try to embrace this change for a few weeks and see how it goes.  Do press "save as draft" at the bottom each time and I'm confident you'll notice no difference to your old workflow.  If you ever have a problem, that's when the recover is there to save you.

    I'd be really keen to hear your thoughts after a few weeks.

  • Avatar
    Helen Cross

    Hi Joel ..  could we maybe have the - save as final - save as draft - buttons at the top as well as the bottom - might remind us to use them - maybe they could also be a color so they stand out (different colors maybe)  .. assuming this will work on templates we have set up ourselves too.

     

    Thanks ... Helen :))

     

  • Avatar
    Joel Friedlaender

    @Helen, thanks, great suggestion.

  • Avatar
    Tyraus Farrelly

    The save as final - save as draft - buttons at the top would greatly help me also, tedious to have to scroll all the way back to the top when using a long form!

    Tyraus

  • Avatar
    Bruno Pinto

    @Helen, @Tyraus We are working on that! :)

  • Avatar
  • Avatar
    Tyraus Farrelly

    This is much better thanks!

    There is one more change I think would help greatly, the auto save function meant that a save to draft would happen while still having the form open.  Now every time you save, the form closes.  If we are saving on the go it means we have to re-open the form every time.   I would rather the save to draft kept the form open and we could close out manually when we go into another function/page.

    Thanks, Tyraus

  • Avatar
    Jonathan Lubetzky

    Looking good guys,

    However, I still liked how the autosave draft function would appear in the right side column that would update as you completed the form. If you have a long template to complete then the autosave draft would provide a summary of what you had written real time so you didn't need to scroll through the working template. Obviously the draft appears in the right column once you click save draft, but I'd rather not have to create a draft just to see that I had entered all the info I wanted, before saving it as final. For me its about time saving and less page loading. If you could add that functional aspect back in that would be great!

    Cheers

    Jonathan 

  • Avatar
    felix ladyzhenskii

    Hi Joel and Team,

    I am still having some issues with the new set up. Once the notes are started, during the exam, more info is added as I go along, saving as a draft each time I write something is not practical (since the notes are closed off as a draft). When you seeing patients back to back, there is no time to fiddle with "save as draft" , and then remember to add something else to the notes, and keep going backwards and forwards. I will often open new notes for the next patient in new window and keep going that way. With the current autosave, you have to go to the specific patient, and the specific note template to see the autosaved notes......There is no way of knowing which patient has notes saved as an autosave. I also often finish my notes at home, from a different computer, so unless I had the notes saved as a draft, I can not access them.

    In regards to the loss if internet connection etc. If that happens, you cant actually get into the notes in the first place, so the current autosave function will not be of much help.

    What you had previously worked well, it was fast and effective, so I am not sure why fix something that was not broken???

    Cheers,

    Felix

  • Avatar
    Tyraus Farrelly

    Hi Joel,

    Ultimately I agree with Felix, the old system worked great for me.  If the internet went down I also found I could go back in my browser and recover most of the time.  Actually every time!

    I didn't have any issues with the speed when auto saving.

    I realise that the auto save is being used in a different way than you initially intended, but it has made the system so much better.  I do remember when it was first introduced and I thought this was a fantastic upgrade.  Unfortunately it feels as though we have downgraded with this upgrade!

    On the whole very happy with cliniko though, keep up the great work.  You always listen and try to implement our requests, much appreciated.

    Thanks, Tyraus

  • Avatar
    Helen Cross

    Hi Joel & team ... thanks for the prompt adding of save options at the top of the page.  It's awesome.  I do agree with the guys though that it is a nuisance that the form closes every time you save.  

     

    Have a great day ... Helen :))

     

  • Avatar
    Luke MHC

    Hi Joel,

    This new system of notes and drafts etc is creating a list of problems within my whole team.

    1. Adds more time to notes

    2. Have to exit and then re-enter notes to make small modification

    3. the autosave was awesome, and my team are forgetting to save as draft and then having to retype notes

    Now ads more time within treatment especially when we are booked back to back and don't have time

    I am seeing quite a few people agree.  Can you revert to the old system?

  • Avatar
    Joel Friedlaender

    Hi Everyone,

    Thanks for the extra comments.  We are still keen to give this more time as it looks like the majority of issues are caused when people aren't pressing the "Save as Draft" button.  We think that's a bad habit that we brought in with the previous way this worked.  We do want people pressing the save button when they finish typing a note.  As I mentioned earlier, the restoring of notes should be something that happens in very rare situations and shouldn't be something that's effecting you daily.

    I am monitoring this closely and we have done plenty of our own usability testing and will continue to do so.  For now we are not planning to revert this but we are considering other ways to solve the problems mentioned.  Some ideas we are considering (and just considering now, no set plans):

    • Automatically creating a draft treatment note when you mark a patient as arrived, this would then mean you have the draft in place and just edit it each time.
    • Linking the treatment notes to the appointment (which we were already planning to do), so you can easily see from the calendar which appointments have notes or not.
    • Generating a draft as you first go to create the note, so that it appears on your dashboard right away.  You'll still need to press the save button though as you make changes.

    These are some of the things we are thinking through now.  We want writing treatment notes to continue to be great, and we'll do our bit.

    Joel

  • Avatar
    Ian Lawson

    All 3 ideas you are considering there are excellent, and almost essential in my eyes to start using treatment notes. At present we're just using good old pen & paper till a treatment note gets connected to an appointment automatically, that way we know the notes have been done. Too easy to miss appointments and not do the notes if it's not an automatic thing.

  • Avatar
    Jonathan Lubetzky

    Hi Joel, 

    I am still missing the autosave draft function that would appear in the right side column and would update as you completed the template. What is the chance of adding this aspect back to what you have already done?

    Cheers

    Jonathan

  • Avatar
    felix ladyzhenskii

    Hi Joel,

    I agree with Jonathan. The new system is not very practical. I have been coming across saved drafts that I had no idea they were there, with no date stamp, and by now no recollection of what happened in that session....

    Please bring back the old system.

    Cheers,

    Felix

  • Avatar
    Tyraus Farrelly

    Hi Joel,

    Sorry but the treatment notes change is still a big issue for me, and it appears others.  I have come across notes that require recovering from patients' previous visits, (these have obviously not been saved at the time for whatever reason) .  The notes are recovered but now have a date stamp for the day they are recovered instead of the day they were actually written.  I have to say, besides how messy this now becomes and the total inconvenience of having the wrong date stamp, I am a little worried there could also be legal issues for us that arise. 

    For those who do regular insurance work, there are many times when treatment, as well as all other patient notes, are subject to a Subpoena.  If the patient file hasn't been opened since the last unsaved note to when the subpoena is issued, it could look like we are changing treatment notes, even though they were written on the day of treatment.  This may look like we are changing the treatment notes after the fact!

    I know you say the auto save was not how you intended people to use the note section of cliniko, but in a busy practise, jumping from screen to screen in cliniko is happening all the time and remembering to constantly save and then go back into the closed note is extremely ineffecient. The recovery of notes is also very very slow, as we have to wait for this to end before starting a new patient note.

    Is there a reason why you don't want to go back to the auto save function we previously had, because like it or not, from and END USER PERSPECTIVE, this was far far better than what we have at the moment.

    Please consider reverting back or make some changes ASAP as this is now an issue which is constantly using up needless extra time in our day to day use of cliniko.

    Regards, Tyraus

  • Avatar
    Joel Friedlaender

    Hi All,

    Thanks for continuing to provide feedback here. I really appreciate you giving it some time to settle in before coming back to raise it again.  

    Clearly there's a problem with the change.  I don't know yet if the fix is to revert it or to further improve it in other ways but something will need to be done here.

    We'll have a brainstorming session here with the team and come back with how we plan to fix it.  We'll make sure to get attention on this quickly once we know what we're doing.

    I'll update more again soon and thanks for your patience and continued feedback.

    Joel

  • Avatar
    Tyraus Farrelly

    For me, the previous system worked great!

    It does however need to be linked to the patient's appointment somehow.

    Regards, Tyraus

  • Avatar
    Joel Friedlaender

    Personally I have some ideas about linking to the appointment that might solve all the trouble, but I'll chat to the team before going into detail.

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