IDEXX Cornerstone Software

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Caution, client may bite: the do’s and don’ts of client alerts

Ever have a challenging client situation occur and you need to document it? Where do you put it in Cornerstone, since it is not necessarily patient history (unless the situation impacts patient care and safety). Afterall, you may want the information to be internal only, and not visible/shareable outside the practice through patient records.

Occasionally, a client requires special attention (for example, if they are hearing impaired or there is a language barrier) or the client has put your team on edge for various reasons. Before entering anything, ask yourself “does this really need to be documented?” Also consider if the situation arose from a hospital policy, was the client duly informed of it prior to the visit?

Sometimes, a bad day goes a little too far for some people. Your client could have just gotten some very upsetting news and the imperfect visit at your practice sends them over the edge. In this and any case, research the situation and consider before taking any action:

  1. Is this a one off or a chronic / repeatable situation? Try to uncover the root cause.
  2. Is this solely client focused, or is the patient affected as well? In some cases, may be best to place a note under both the client and patient
  3. Who needs to know? Anyone interacting with the client or only specific team members? This can determine if an alert is necessary.
  4. Is this for Internal use only or part of the patient record?

Where in Cornerstone should you place this? Based on the four factors above, make an entry by one or combination of the following methods. Keep in mind any entry should be factual and free of emotion or judgement, and written as though a lawyer or state board were reviewing your records!

Method Alert option1 Editable/ Removable Patient Clipboard1 Check in report2 Patient History report Other reports Other notes
Client Prompt Alert
Client prompts & notes tab
    Client Prompts report Document bookmark field
120 characters length limit
Can use alert to point to Notes
Client Note   Client prompts & notes tab   n/a Document bookmark field
More discrete on screen than prompt
Client Account comment     Client Account tab     Client Account History report4 Best for financial comments only
Patient Prompt Alert
Patient prompts & notes tab
  Patient Prompts report Document bookmark field
120 characters length limit
Can use alert to point to Notes
Patient Note   Tab location   n/a Document bookmark field
More discrete on screen than prompt
Document (medical note or correspondence) Tentative or draft status only
Summary, Text, Medical Note history tabs n/a Can be printed, emailed, shared
Document bookmark field
Entry types can be excluded from patient history, but not specific templates

Regardless of how you enter it into CS, heed these do’s and don’ts to avoid potential issues:

  • Do think (and take a few breaths!) before you write that entry
  • Do use prompts and notes, and when necessary, documents
  • Do use alerts sparingly.
  • Do keep it professional
  • Don’t use defamatory or unprofessional language
  • Do state the facts only
  • Don’t use emotional commentary
  • Do be brief: think tweet!
  • Don’t rant and write a short story. Less said the better!

And a parting tip for the truly “terminated” clients that just sometimes cannot be avoided.

  • Inactivate the client (this will also inactivate all patients)
  • Change to a No Service alerting classification (Controls > Classifications > Client). 
  • You can also use the Write Off function to ensure they cannot be invoiced out and users alerted when scheduling an appointment

  1. Based on alert suppression settings (Controls > Defaults > Practice & Workstation > Alerts)
  2. Based on check in report print option settings (Controls > Defaults > Practice & Workstation > Check-in > Check-in print options)
  3. Security based. Voided entries are still considered part of the record. Note: only quick text and enhanced type documents can be voided.
  4. Account comments can be hidden

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