> ## Documentation Index > Fetch the complete documentation index at: https://mintlify.com/appertafoundation/openeyes/llms.txt > Use this file to discover all available pages before exploring further. # OphCoCorrespondence Module > Letter generation and clinical correspondence in OpenEyes # OphCoCorrespondence - Letters The **OphCoCorrespondence** module provides robust letter generation and clinical correspondence capabilities, enabling efficient communication with GPs, patients, and other healthcare providers. ## Overview OphCoCorrespondence handles all clinical correspondence needs: * GP clinic letters * Patient letters * Internal referral letters * Discharge summaries * Investigation result notifications * Specialist-to-specialist correspondence The module supports both printed and electronic letter distribution, with template-based content generation and digital signature capabilities. ## Core Element - ElementLetter The primary model for correspondence: ```php theme={null} ElementLetter ``` ### Key Properties **Header Information:** * `use_nickname`: Whether to use patient's preferred name * `date`: Letter date * `site_id`: Sending hospital site * `direct_line`: Contact phone number * `fax`: Fax number (where applicable) * `clinic_date`: Date of clinic visit referenced **Recipient Details:** * `address`: Recipient address (GP, consultant, patient) * `to_subspecialty_id`: Destination subspecialty for internal referrals * `to_firm_id`: Destination team/firm for internal referrals * `to_location_id`: Destination location **Content Fields:** * `introduction`: Opening paragraph * `re`: Subject line (patient details) * `body`: Main letter content * `footer`: Closing paragraph and sign-off * `cc`: Carbon copy recipients **Status & Workflow:** * `draft`: Draft status (not finalized) * `print`: Marked for printing * `print_all`: Print all attachments with letter * `locked`: Letter finalized and locked from editing * `is_signed_off`: Electronic signature applied * `letter_type_id`: Type of letter (GP, patient, etc.) **Urgency & Clinical Flags:** * `is_urgent`: Urgent correspondence flag * `is_same_condition`: Referral for same condition **Supersession:** * `supersession_id`: Links to letter this replaces (for corrections/addenda) ## Letter Types Configurable letter types for different correspondence needs: Standard clinic letter to general practitioner documenting examination and management Letter to patient explaining diagnosis, treatment plan, or test results Referral to another subspecialty within the same organization Referral to another hospital or specialist service Summary letter on discharge from service Notification of investigation results ## Letter Templates The correspondence module uses powerful templating to auto-populate letter content from clinical data. ### Template Structure Letters consist of modular sections: **Purpose:** Opening paragraph establishing context **Common Content:** * Thank you for referring this patient * I reviewed this patient in clinic on \[date] * This patient attended for \[appointment type] * Re-referral regarding \[condition] **Macros Available:** * `[clinic_date]` - Date of appointment * `[appointment_type]` - Type of visit * `[referring_doctor]` - Name of referring clinician **Purpose:** Main clinical content **Typical Structure:** 1. Presenting complaint/reason for visit 2. Relevant history 3. Examination findings 4. Investigation results 5. Diagnosis 6. Management plan 7. Follow-up arrangements **Auto-Population:** Content can be automatically inserted from: * OphCiExamination elements * Operation notes * Investigation results * Medication changes * Diagnostic codes **Purpose:** Closing and action points **Common Content:** * Follow-up arrangements * Ongoing treatment plan * When to seek further help * Contact information for queries * Sign-off (Yours sincerely, etc.) ### Macro System Powerful macro/snippet system for dynamic content: * `[patient_name]` - Full name * `[patient_firstname]` - First name * `[patient_lastname]` - Surname * `[patient_title]` - Title (Mr, Mrs, etc.) * `[patient_dob]` - Date of birth * `[patient_age]` - Current age * `[patient_NHS_number]` - NHS number * `[patient_hospital_number]` - Hospital MRN * `[patient_address]` - Full address * `[diagnosis_left]` - Left eye diagnosis * `[diagnosis_right]` - Right eye diagnosis * `[visual_acuity_left]` - Left VA * `[visual_acuity_right]` - Right VA * `[iop_left]` - Left eye pressure * `[iop_right]` - Right eye pressure * `[current_medications]` - Medication list * `[allergies]` - Patient allergies * `[management_plan]` - Treatment plan * `[clinic_date]` - Date of appointment * `[clinic_time]` - Appointment time * `[clinic_location]` - Clinic location * `[consultant]` - Seeing consultant * `[next_appointment]` - Follow-up date * `[follow_up_period]` - Interval to next visit * `[gp_name]` - GP name * `[gp_address]` - GP address * `[letter_date]` - Date of letter * `[site_name]` - Hospital name * `[site_address]` - Hospital address * `[direct_line]` - Contact phone number ### Custom Snippets Users can create reusable text snippets for: * Common clinical findings * Standard management plans * Procedure explanations * Patient advice paragraphs * Discharge instructions **Example Snippets:** ``` Snippet: "diabetic_retinopathy_background" Text: "Retinal examination revealed background diabetic retinopathy with scattered microaneurysms and dot hemorrhages. The macula appears healthy with no evidence of macular edema." Snippet: "cataract_post_op" Text: "The patient has made an excellent recovery from cataract surgery. The eye is quiet with the IOL well positioned. I have advised to continue the drops for a further 2 weeks and then stop." ``` ## Letter Generation Workflow From patient record, create new correspondence event Choose appropriate letter type (GP, patient, referral, etc.) Choose or enter recipient details (auto-populated for GP letters) Choose from available templates for letter type Template fills with data from recent examination/event Customize letter content, add snippets, modify auto-populated text Specify carbon copy recipients (patient, consultants, etc.) Check letter content, formatting, and recipient details Save as draft or finalize and lock letter Apply signature and send via print or electronic channels ## Letter Workflow States ### Draft Mode Letters start in draft mode: * Can be edited and revised * Not visible to recipients * Not printed * Can be deleted **Draft Indicators:** ```php theme={null} $draft = true $locked = false ``` ### Locked/Finalized Once finalized: * Content locked from editing * Available for printing * Visible in patient record * Cannot be deleted (only superseded) **Finalized Indicators:** ```php theme={null} $draft = false $locked = true ``` ### Signed Electronic signature applied: * Digital signature captured or credential-based signing * Timestamp recorded * Signing clinician identified * Letter authenticated for legal purposes **Signature Properties:** ```php theme={null} $is_signed_off = true ``` ### Superseded Corrections or addenda: * Original letter remains in record * New letter created with `supersession_id` linking to original * Both versions available for audit trail * Clear indication that newer version supersedes **Supersession Link:** ```php theme={null} $supersession_id = [original_letter_id] ``` ## Distribution Methods ### Printing **Batch Printing:** * Letters marked for printing added to queue * Bulk printing by date, clinic, or user * Print all attachments option * Print count tracking **Print Formats:** * Standard letter on headed paper * Patient-friendly format * Prescription-style for medication changes * Fax cover sheet option **Print Tracking:** * Printed by user recorded * Print timestamp captured * Reprint audit trail ### Electronic Distribution Direct messaging to GP clinical system via NHS mail or spine integration Secure patient access to letters via online portal Secure email with encryption for appropriate recipients Legacy fax transmission where required ## Internal Referrals Special handling for internal referrals between subspecialties: ### Referral Properties ```php theme={null} $to_subspecialty_id // Destination subspecialty $to_firm_id // Destination team $to_location_id // Destination clinic location $is_same_condition // Whether same condition as current care $is_urgent // Urgency flag ``` ### Referral Workflow 1. **Create Internal Referral Letter**: Select internal referral letter type 2. **Choose Destination**: Select subspecialty and firm 3. **Indicate Urgency**: Flag urgent referrals 4. **Provide Clinical Details**: Complete referral with reason and relevant information 5. **Submit**: Referral appears in destination subspecialty worklist 6. **Tracking**: Monitor referral status and acceptance ## Letter Contact Rules ```php theme={null} OphTrOperationbooking_Letter_Contact_Rule ``` Automatic determination of letter recipients based on rules: * Patient type (new, follow-up, post-op) * Clinic type * Diagnosis * Procedure performed * Referral source **Example Rules:** * Post-operative letters always CC to patient * Diabetic retinopathy letters CC to diabetes team * External referrals CC to referring consultant * New patient letters include full clinical details * Follow-up letters may be summary format ## Configuration ### Module Setup ```php theme={null} 'modules' => [ 'OphCoCorrespondence' => [ 'class' => 'application.modules.OphCoCorrespondence.OphCoCorrespondenceModule', ], ], ``` ### Template Management Administrators can: * Create letter templates * Define macros and auto-population rules * Set default templates per letter type * Configure template availability by subspecialty * Manage snippet library ### Site Configuration Per-site settings: * Hospital letterhead details * Contact information * Digital signature configuration * Print settings * Electronic distribution endpoints ## Integration with Clinical Modules ### OphCiExamination Integration Letters auto-populate from examination data: * Visual acuity measurements * IOP readings * Examination findings (anterior segment, fundus) * Diagnoses * Management plan * Follow-up arrangements * Clinic outcome ### OphTrOperationnote Integration Post-operative letters include: * Procedures performed * Surgical findings * Complications (if any) * IOL details (for cataract surgery) * Post-operative instructions * Follow-up plan ### OphDrPrescription Integration Medication information: * Current medications * Medication changes made * Stopped medications * Reasons for changes ## Best Practices Send letters within institutional targets (typically 7-10 days of clinic) Use clear, jargon-free language especially for patient letters Verify GP and patient details before finalizing Include all relevant clinical information for continuity of care Clearly state any actions required by GP or patient Carbon copy relevant parties (patient, other specialists) ## Advanced Features ### Bulk Letter Generation Generate letters for multiple patients: * Post-clinic batch processing * Similar content for cohort (e.g., DNA letters) * Automated result notification ### Letter Analytics Track time from clinic to letter dispatch Monitor correspondence volume by clinician/clinic Analyze which templates are most used Report on letter completion targets ### Version Control Complete audit trail: * All letter versions retained * Modification history * User attribution * Timestamp tracking * Supersession chain ## Troubleshooting **Possible Causes:** * Data not present in source examination/event * Incorrect macro name * Examination not recent enough * Configuration issue with macro definition **Solutions:** * Verify source data exists * Check macro spelling * Select specific event to pull data from * Review macro configuration **Check:** * Required fields completed (recipient, date, etc.) * User has permission to finalize * No validation errors in content * Event is saved **Solutions:** * Update patient GP details in demographics * Manually enter address * Check GP database integration * Contact PAS/registration team ## Related Modules Clinical data source for letter content Surgical documentation for post-op letters Letter generation workflows ## Further Information Creating and managing letter templates Configuring electronic correspondence channels