Frequently Asked Questions about E-mailed Notes
Why was I sent an e-mail message from a DHMC provider that has a web link (URL) in it?
What will I see when I open the web link in the message?
Emailed notes open for me, but it takes a long time. Is there any way to speed up that process?
Is there some way I can save a copy of the note itself in my local electronic medical record system?
I don't like this system. What are my other options for receiving clinical communication from DHMC?
Why are we still receiving paper copies of some types of notes? We selected email.
I have a question or problem that isn't covered on this list. Who can I contact for help?
Why was I sent an e-mail message from a DHMC provider that has a web link (URL) in it?
You received that message because a patient who has named you as their PCP or referring provider has received care at Dartmouth-Hitchcock, a D-H provider wants to send a note or report to you, and you have indicated to us that you wish to receive routine clinical correspondence via e-mail. The web link, when opened, will establish a secure encrypted connection to our system and use that to display the note on your computer.
What will I see when I open the web link in the message?
Your web browser (after a prompt to confirm you want to open the file) will display a fully formatted version of the note, or report that is stored in our Clinical Information System.
I used to receive e-mail from DHMC providers that had the text of the note in the e-mail message. Why is that text no longer there?
Including the full text of the note in the body of the e-mail message was less secure than the new method. We made the decision to use the best available technology to keep these notes private and confidential.
E-mailed notes open for me, but it takes a long time. Is there any way to speed up that process?
The speed with which the links open depends in part on the speed of your Internet connection, but even more so, the performance level of your computer. Opening the link will make use of your web browser (Internet Explorer for most users) and your word processing software (Microsoft Word for most). These programs open and display the note faster on computers that are reasonably current and which have adequate memory (RAM).
If you are having performance concerns, please contact your local computer support to make sure that Microsoft Word and Internet Explorer are functioning as efficient as possible. Contact Affiliate.Access@hitchcock.org if those programs are launching quickly but the notes still take a long time.
Can I save or bookmark this link in my local system and use it to open the note if necessary in the future?
The link will remain active for 90 days after the message was initially sent from our CIS system. So it should not be regarded as a means of accessing the information far into the future. You do have the option of saving the note into your local system when you view it or printing out a copy if you are maintaining paper charts.
Is there some way I can save a copy of the note itself in my local electronic medical record system?
Yes. The file that is displayed through your web browser is a Rich Text File (RTF) that can be saved on your local system. It is also possible to select and copy the contents of the note and paste it into your local electronic medical record. Your local computer support should be able to show you how to do that. Remember in all cases, that you are handling Protected Health Information (PHI) and that it needs to be shared and stored on secure systems in accordance with HIPAA regulations and your local Health Information policies.
Can I print the note?
Yes. In most web browsers there is a "Print" button on the tool bar, a Print option under the File menu, or you can hold down the Ctrl key on your keyboard and press P.
When I click on the URL, my browser opens, and then displays a message that says "this note does not exist". Why?
That error condition usually is the result of the original recipient of the note forwarding it to another e-mail address and attempting to open it from that second account. When the message is forwarded, some e-mail programs will insert “line breaks” into the long URL that points to the note. There are several strategies for dealing with this problem, depending on your e-mail system and the work flow in your office. Contact us at Affiliate.Access@hitchcock.org or call 603-653-1420 and ask to speak with an analyst about the problem.
When I click on the URL, an error message appears stating that the link is using the wrong port for SSL. What does that mean?
This is a problem that will require the help of your computer network support personnel to fix. The error means that the server on your network that handles traffic out to the internet is blocking the type of connection we use to securely transmit the notes. Your network support will have to “configure the proxy server to allow HTTPS via Port 598 to cisweb1.hitchcock.org and cisweb2.hitchcock.org.” You can forward that message to them, or contact us at Affiliate.Access@hitchcock.org or call 603-653-1420 and we will work with your network staff to get the access to work.
I don't like this system. What are my other options for receiving clinical communication from DHMC?
The other preferences that are available to you are Fax and U.S. Mail. You can call our Physician Connection Line at 866-346-2362 to change your preference.
I can open the URL, but when I forward the e-mail to my staff to print and file, they get an error message when they try to open the link. Why?
It is important to understand that you are handling Protected Health Information. Any forwarding should be limited to within your practice, and only when sharing the information is necessary for treatment, payment, or health care operations.
Some e-mail systems do have problems forwarding the links. When the message is forwarded, the e-mail program inserts “line breaks” into the long URL that points to the note. There are several strategies for dealing with this problem, depending on your e-mail system and the work flow in your office. Contact us at Affiliate.Access@hitchcock.org or call 603-653-1420 and ask to speak with a Regional IS Analyst.
Why are we still receiving paper copies of some types of notes? We selected e-mail.
The communication preference you have stated will be applied to all routine clinical communication that is sent directly from the DHMC electronic medical record system, CIS. Almost all of our clinical documentation is processed through that system, but there are a few instances, where older equipment or systems are not directly linked to CIS. Reports and notes from these areas will still be manually processed, and from these areas you will receive regular mail or faxes.
I often refer Patients to DH Manchester, DH Nashua or one of your providers at Norris Cotton Cancer Center North, or a regional site or outreach clinic - how will I receive notes from these locations? Will it be based on my preference?
Yes. Providers at those sites document their care in the CIS system, and will be sending you the information from within CIS in accordance with your preference.
I often refer Patients to DH Concord or DH Keene. How will I receive notes from these locations? Will it be based on my preference?
Dartmouth-Hitchcock providers who work at those locations document their work in the local Electronic Medical Record systems maintained by Concord Hospital and The Cheshire Medical Center respectively. Those systems are not "aware" of the preference you have supplied to DHMC.
I have a question or problem that isn't covered on this list. Who can I contact for help?
The DHMC Regional Information Systems team is available to assist with any questions or problems. You may either e-mail them at Affiliate.Access@hitchcock.org, or call 603-653-1420 and ask to speak with a Regional IS Analyst.
