blankev wrote on Thursday, May 22, 2014:


Select ‘Transactions’ at the top of the Patient Summary to go to the Patient Transactions page.

The Transactions page contains two basic form types. A simple form for internal transactions such as patient requests or billing transactions, and a referral form.

        Transactions => Referral -pages are created with the following files (Basic programmer-knowledge needed to change these) 

            ../library/ (General settings for the complete OpenEMR program)
            ../interface/patient_file/transaction/transactions.php (the file used to decided if there are transactions available.)
            ../interface/patient_file/transaction/print_referral.php (Labels, Tables and Fields to be used in the result => referral_template_html transaction page to be printed)
            ../interface/patient_file/report/print_custom_report.php (File with information show practice_logo.gif in report and how to get database information in the transaction Fields)
            ../sites/default/referral_template.html (HTML page with formatting and lay-out for printing, also used for empty referral print) 

There are two types: Internal and external

  1. If I want to use the external type, how can I add a different template?
  2. If I want to use the Internal type, how can I add a different template?

There is as far as I can discover only one type of transaction print design (External referral), but I need at least three different designs, more or less like the Referral sheet, but with less fields included.

I need this transaction changes till the new V 4.1.3 will be official and ready for use.

Tnx in advance.

fsgl wrote on Thursday, May 22, 2014:

Hi Pimm,

As you already know, in addition to the Referral form, there is another formatted form, Counter-Referral. There are also the free text forms, Patient Request, Physician Request, Legal and Billing in the Transactions group.

In the above cited Wiki article, Rod’s distinction of internal versus external refers to the source of the data. Referral, Patient Request, Billing require information from the practice; hence internal. With that logic the remaining forms are then external.

Something similar to his Template for Patient Document can be found under Pop-up->Letter.

It would be simpler to use what’s on hand rather than to change the .php files.

What are the other templates you wish to create? We will try to offer more ideas once we know the specifics of your needs.

fr4nkie wrote on Thursday, May 22, 2014:

Slightly off-topic:

I always found the word “transactions” to be out of place in regards to creating a referral. Transaction implies exchange of goods to me. Wouldn’t it make more sense to separate the link for referrals? It also seems the other transaction types are just a simple text field to leave a general note which is fairly redundant considering the note widget on the main demographic page.

fsgl wrote on Thursday, May 22, 2014:

“Transactions” would be appropriate in the context of an exchange. For a referral there is an counter-referral.

These forms are correspondence meant for sending outside of the practice rather than notations to be retained in the medical record.

blankev wrote on Thursday, May 22, 2014:

What I want to accomplish are administration referrals to Insurance Agency to give permission for certain referrals.

  1. With diagnose
  2. Without diagnose
  3. NUMBER 1. Is used for two different Insurance Agencies.
  4. NUMBER 2. is used for many different Insurance Agencies.

Specialist name is required, with ADD new option.
Diagnose is optional (even better with an hidden result if empty)
Insurance Agency is required, with choice.
General demographic registration can be required or optional

The other referral is more like the official referral letter, without counter referral part and without the client’s part. This last type contains usually more information and the Report function in Summary can be used for this.

The nice part of one of the options I saw, was the choice to make a specialist sort in the first place. (Pop-up options in the lower left menu bottom choices) With more than 400 referral names it can become quite tedious to find the correct name if only the Facility name is mentioned. If the specialist is not connected to a facility you get the name, still hard to find an name, but usually this is no problem.

BTW Franky’s observation of the text option field is correct. But I can’t find the files that make the decision to make an external referral or make the one with only text option. can add different internal forms with the Administration List ADD. (Not for the external ones)

Now I am taking the route of Layout based forms, but this is as complicated as changing the Referral Letter (Left lower option), but with the use of examples of Demographics and History I will succeed, but with some real devastating time investment. (In other words, not so easy)

fr4nkie wrote on Thursday, May 22, 2014:

The only transaction with an internal/external variable is the referral.

As far as the other transaction types, the only option is text input. Also looks like the referral/counter referral is the only transaction that can be printed by itself. All other transactions must be printed via the patient report module, where all entries are printed on the same page. This is what makes the non-referral transactions and notes redundant, in my opinion. I understand they may differ conceptually, but functionally, they are the same.

For what you’re trying to do, Pieter, I would suggest trying to add two new transaction types based on the current referral form (i.e. copy and paste) and customize as needed.

You’re also spot on about the “Refer To” defaulting to facility name. This is a huge issue if you refer to multiple providers at the same facility. We’ve had to go through and edit our address book to remove facility name to circumvent this.

Another bug I noticed while we’re on the topic is that you cannot edit the Refer To field after the referral is initially saved. The Refer To field will only show local physicians at that point as opposed to all contacts listed in the address book. I’ll submit a bug report on these later today.

mdsupport wrote on Thursday, May 22, 2014:

Agree that non-referral ‘transactions’ are really notes. May need some work to add filtering by category to notes viewer. Also ability to exclude some note categories from patient report printing.

fr4nkie wrote on Thursday, May 22, 2014:

Perhaps “correspondence” would be more appropriate as opposed to “transaction”? Certainly not a big deal, but maybe something that can be reworded to prevent confusion for new users.

mdsupport wrote on Thursday, May 22, 2014:

When any of the standard labels are confusing providers/staff we use translation entry for instant gratification. An example is our practices do not have ‘Clients’. Couple of translation entries make ‘Clients’ -> ‘Patients’.

blankev wrote on Thursday, May 22, 2014:

When I am finished with my Lay-out Based Visit forms and all are included in “Lay-out Based”, I am sure to translate this tab-word into “Layout Based” => “Correspondence”.

Don’t know what to do if I develop more forms that do not have a correspondence content, possibly the Version 4.1.3 is out and I can safely use the Document Templates.

blankev wrote on Thursday, May 22, 2014:

For what you’re trying to do, Pieter, I would suggest trying to add two new transaction types based on the current referral form (i.e. copy and paste) and customize as needed.

I did make three more types of Transactions in ADMINISTRATION => LIST but these are of the one-text-field type, I cannot find the Referral type of Transaction.

YES, if you can explain me how to create the Referral type of Transaction ?Copy => Paste? I would be grateful!

fsgl wrote on Thursday, May 22, 2014:

Changing the layout for Referral is a good option.

Setting up a template in Popup->Letter requires less work and customization. There is a template, Referral_1, in the 2013 Demo for Jane Seymour. Look in the Template drop down menu.

Would suggest putting the Insurance Agencies in the Address book with a person’s name because the search does not work with just the organization name. Usually you would know whom you want for the specialist. Instead of a search through the Address book, just type his name into the template.

Same for the diagnosis or reason for the referral. Just enter it.

The tricky part occurs if more information is required about the specialist. In that case, the inserted special fields will have to be directed to the specialist instead of the Insurance Agency. A template can be created for the 2 most frequently used agencies with their name, address, etc. formatted and another template where these items are left blank for the other agencies.

A nice feature of Letter is the ability to have the final referral authorization request as a .pdf file that can be emailed, thus saving time and postage. Hopefully your email system is encrypted to protect patient confidentiality.

mdsupport wrote on Thursday, May 22, 2014:

Referrals should not be tied to encounters. An encounter may result in referral but converse is not always true.

For your task, you will need to create additional copies of Referral layout with desired changes. Then you will need to add/change few lines in current referral form where the underlying layout (‘REF’ as key) is selected. This code should be changed to consider current transaction type and choose appropriate layout for display and printing. These changes will give you flexibility of dropping fields from standard form but not add new ones unless you have further changes to code and database.

blankev wrote on Thursday, May 22, 2014:


The file to customise available inserts for the Lower left Referral-letter.

I could locate the correct field-name in the Database.

Did at least three Copy compare and Paste changes into the file. (Need to know some PHP rules.) I included the phone number of the Specialist, AND IT WORKED!!!

This sure will serve my purpose!

Tnx for the support and INFO on this topic.

As from now for me: this topic is closed.

fsgl wrote on Thursday, May 22, 2014:

Very gratifying to know that you won’t have to live recklessly.

When 4.1.3 becomes available, it will be Template Heaven.

I was about to ask how you located the .php file to add the specialist’s phone number when I happened to look at the URL of the Letter form. The answer was as clear as day. This works only with a dialog box.

Always learn something new with each visit to the Forums.

blankev wrote on Thursday, May 22, 2014:

What I do to find a file is: to work in OpenEMR, go to the most likely screen and from the part I think is used for my problem, open this in a NEW TAB in the browser. Most of the time this gives an indication on where to find the file.

To include the Diagnose in this referral might still be some kind of headache. But so far I included the phone number of the Specialist, the S.S. number of the client.

Copying the files structure should be easy in the editor. Still a bit primitive compared to Rod’s latest Document templates for Version 4.1.3… hahaha, I see the fun of OpenEMR again.

If including Diagnose is too complicated, I might even consider the option to write the Diagnose with a pen. Hope they can read my handwriting still after so many years of digital writing.

fsgl wrote on Thursday, May 22, 2014:

Fairly easy to add a Diagnosis field to Demographics from Layout.

The Letter form pulls info from the patient_data table.

The next step is merely to replicate what you did for patient’s Social Security number.

It’s magical.

blankev wrote on Friday, May 23, 2014:

So the insurance thing will cover with three Letter types most of the Clients. Only one type about 10 % has to be filled by hand.

But in you sample there are three lines to fill by hand. The third one you forgot was the line where there has to be signed… :wink:

But how to include the Diagnose optional. I suppose I have to look into the Document template and Referral transaction. BTW there is also Referral option in the left hand lower menu. But that needs a lot of work. First the insurance referral.

Most probably with the MU2 component finished there will be a V 4.1.3 version with all of the Ubuntu, Linux, VM versions, Windows and other options, if Brady can find enough time to spend…

fsgl wrote on Friday, May 23, 2014:

If you want a signature line, it will cost 5 Bitcoins (just joshing).

Popup Refer requires, thus not a viable option.

There are two ways to have Diagnosis:

  1. Any unused part of Demographics can be recruited for Diagnosis, i.e., User Defined (there are 4 of them). Type a diagnosis in that space, add User Defined to the .php file and the template; then it should pop up in the referral letter.

  2. You can add a new field, Diagnosis, by going to Administration/Layouts/Demographics. Then add to the .php file and the template.

The result should be a document that requires only one manual input of a signature with everything else having been automated.

The time line for MU2 will probably be expanded because nearly everyone is not ready. Consequently, difficult to tell when 4.1.3 will appear. Popup Letter should serve well in the interim.

blankev wrote on Friday, May 23, 2014:

Rather strange to have an diagnose in Demographics, or change the Diagnosis every time I want to refer a client to another Speecialist with a different Diagnosis. BTW the field is already in Referral (the Table where the referral Doctor fields are included) To use the Diagnoses field it needs some information and that is included once the Transaction and Referral is made.

My theoretical solution is to make it obligatory (1) to make a Transaction Referral that includes the diagnosis. (2) This diagnosis can be used in the Letter as you mentioned above.

First transactions, make a referral. Next make the correct Letter for the Administrative acceptance referral.

Leaves me with two lines. Insurance company name and signature. (The last one can be a picture, but some training of the signature is not so bad :wink:

Question: Any idea on how to include a picture in the Letter?