Clinical entries are the primary unit of documentation in Dermi Atlas. Each entry represents a patient visit or appointment and serves as a container for clinical notes, images, and image comparisons. Entries are always associated with a specific patient and track the appointment date, the physician who created them, and any tags applied.
Before creating entries, a patient record must exist. For guidance on patient records, see Managing Patients.
Creating an Entry
To create an entry, navigate to a patient's entries page and select "Create Entry." The system creates a new entry with the following defaults:
- Appointment date set to the current date and time
- Notes field empty
- No workspace images
- No comparison groups
- All three sections expanded (workspace, comparisons, tags and notes)
After creation, the system redirects to the new entry's detail page. The patient's entry count is incremented and the patient's last appointment date is updated to reflect the new entry.
Prerequisites
- A valid license is required.
- An active user session is required.
Entry Detail Page Layout
The entry detail page is organized into a header area and three collapsible sections.
Header
- Back arrow: Returns to the patient's entries list. The control is labeled "Back to All Entries" and the destination page is titled "All Entries."
- Sync status pill: A single pill carrying the current save-state glyph alongside a count of the other sessions with this entry open. Opening it shows a details popover with the status phrase, the last-saved timestamp, and a sentence stating whether the entry is open elsewhere. The status phrases are "Loading", "Saving", "Saved", "Save Conflict", "Save Failed", and "Offline".
- Refresh control: Reloads the entry from the server. When a save has failed or conflicted, it is replaced by a discard-and-reload control and a retry control appears beside the sync status pill.
- Options menu: Lists View Details, Export Entry, and Delete Entry. Export Entry opens the PDF Export Options drawer, where annotation visibility is chosen before the report opens.
Collapsible Sections
- Workspace - The working area for images associated with this entry.
- Comparisons - Comparison groups created from workspace images.
- Tags & Notes - Tag assignments and clinical observation notes.
Each section can be expanded or collapsed independently. The visibility state is saved per entry and persists across sessions.
Appointment Date
The appointment date is displayed near the top of the entry page, alongside the page title, as a datetime picker. It is editable at any time, and changes are synced in real time via WebSocket.
The appointment date serves two purposes:
- Sorting entries in the entries list (either by appointment date or last modified)
- Updating the patient's last appointment date when the entry is the most recent
Images Workspace
The workspace is the entry-level image area where images from the patient's image pool are organized for a specific visit.
Adding Images
Images are added to the workspace from the patient's image pool, one image at a time: each pool card carries an "Add" toggle that places that image in the workspace, and the same control takes it back out. The same image can appear in multiple entries' workspaces.
Workspace Display
Images in the workspace are grouped by effective date, with one group per day. A two-segment toggle switches between Card view, which presents each image as a card, and List view, which presents each image as a compact row. The workspace follows the image pool's date sort and has no sort control of its own.
For each image in the workspace, the following information is shown:
- Thumbnail preview
- Original filename
- Caption
- Effective date (editable per image)
- Assigned tags
Removing Images
Images can be removed from the workspace without deleting them from the patient's image pool. If an image in the workspace is also part of any comparison group, it must first be removed from the comparison group to remove it from the workspace.
Comparison Groups
Comparison groups organize images for before-and-after analysis within an entry.
Creating a Comparison Group
- Select images in the workspace using the "Select" toggle on each card. The toolbar appears as a floating action bar as soon as one image is selected.
- Select "Create Comparison." The action requires at least two selected images; while only one is selected, the hint "Select at least 2 images" is shown beneath it.
- The system checks for duplicate combinations; if the same set of images has already been grouped, a duplicate is not created.
- Images in the group are sorted chronologically by effective date.
- The group is created with an empty caption.
Group Features
- Caption: An editable text description for the comparison.
- Reordering: Groups can be dragged to reorder within the entry.
- Deletion: Individual groups can be removed.
- Split canvas modes: Vertical (side-by-side), horizontal (top-bottom), and grid.
- Overlay canvas: A separate overlay mode is available for additional comparison analysis.
- Alignment: Automatic alignment can be performed on the group of images. For more on alignment, see Automatic Alignment for Image Comparisons.
Viewing Comparisons
Selecting a comparison group opens the full comparison modal. The modal provides split-screen and overlay comparison tools. Canvas performance settings apply to the modal display.
Tags and Notes
Notes
The notes field is a plain text textarea for recording clinical observations. Changes are synced via WebSocket in real time.
Assigned Tags
Tags can be directly applied to the entry through the tag management drawer. Tags are organized by category with color coding, and tags can be selected to toggle assignments. Duplicate prevention ensures the same tag name within the same category cannot be assigned twice. Tag changes are automatically synced.
Inherited Tags
Inherited tags are automatically derived from the tags assigned to images currently in the workspace. These tags are read-only and cannot be directly assigned or removed on the entry. The label "Auto-inherited from images in Workspace" is displayed alongside inherited tags. Inherited tags update when workspace images change (images added or removed) and are displayed in alphabetical order.
Real-Time Synchronization
All entry data is synchronized in real time:
- Synced Data: Appointment date, notes, workspace images, comparison groups, and section visibility, tag assignments.
- Save status: The sync status pill in the header shows the current synchronization state.
- Automatic retry: Failed synchronization attempts are retried up to 3 times at 5-second intervals.
- Manual retry: A retry button appears when synchronization fails persistently.
- Navigation warning: An unsaved changes warning prevents accidental navigation away from the entry while changes are pending.
Entry Listing and Sorting
The entries list for a patient displays entry cards with the following information:
- Appointment date
- Last modified date
- Notes preview
- Workspace image count
- Comparison group count
- Assigned tags
- Workspace thumbnails, a mosaic of up to nine workspace images with a "+N" badge when more exist
Sort Options
Two sort modes are available, each supporting ascending or descending order:
- Last Modified (default): Sorts by most recently updated.
- Appointment Date: Sorts by the entry's appointment date.
Filters
- Date range: Filter by appointment date.
- Tags: Multi-select tag filter.
- Attributes: Filter by workspace image count and comparison group count.
Pagination
Items per page can be set to 5, 10, 20, 50, or 100.
Deleting an Entry
Entry deletion is available from the options menu on the entry detail page. The confirmation phrase depends on the configured deletion policy: "DELETE ENTRY" must be typed under the Standard policy (the default) and under the Recoverable policy, and "PERMANENTLY DELETE ENTRY" when permanent deletion is configured.
On deletion:
- Under the Standard and Recoverable policies the entry is marked deleted and retained for the configured retention period, so it can be recovered. The entry is only permanently removed from the database (and its workspace thumbnail deleted from storage) when the permanent deletion policy is in effect.
- Tag usage counts are updated for all associated tags.
- The patient's entry count is decremented.
- The patient's last appointment date is recalculated from the remaining entries.
- Under the Standard and Recoverable policies the deletion is recorded in the audit trail; permanent deletions are not logged.
After deletion, the system redirects to the patient's entries list. For information on how deleted records are retained, see Configuring Data Retention for Deleted Records.
License Restrictions
Entry creation requires a valid license. Editing entry content (appointment date, notes, tags) is also restricted when the system is unlicensed.
Related Resources
- Managing Patients for patient record management
- Automatic Alignment for Image Comparisons for automatic image alignment
- Audit Logging Configuration for understanding the audit trail
- Introduction to Dermi Atlas for a general platform overview
- Patient Management in Dermi Atlas for an overview of the patient management workflow