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How Dermi Atlas keeps an account's sessions in step across devices on the practice network, with presence indicators, session handoff, live co-editing, autosave, and reconnection.
Clinical documentation rarely happens on a single screen. Photographs are captured on a tablet at the chairside, the entry is written up on the workstation afterwards, and the same record is often reopened between appointments on whatever device is at hand. Dermi Atlas keeps those sessions in step: edits are saved as they are made, carried to the other sessions signed in with the same account, and reported on every editing surface alongside a count of the sessions that have the record open.
Synchronization is part of the deployment rather than a cloud service. It runs entirely inside the practice installation, its status is visible in Dermi Atlas Manager, and devices reach it across the practice network. This article covers how synchronization works, what the sync pill and the session pill report, what happens when two devices work on the same entry, how autosave behaves, and how a dropped connection is recovered.
Each open Atlas page holds a live connection that stays inside the practice network, so record and image data never leaves it.
Once an entry, the Image Pool, or the full body workspace is open, the page follows the patient record it has open, and the clinical entry as well when an entry is open. The only detail shared about a device is its coarse type (computer, tablet, phone, or Atlas Companion); nothing more about the device is visible to the other sessions.
Edits then travel in both directions:
Presence and relayed edits are keyed to the signed-in account, so neither crosses an account boundary. The sessions Atlas reports are the ones opened with the same account on another device or in another tab.
A sync status pill sits in the header of every editing surface: the clinical entry, the Image Pool, full-body photography, the comparison workspace, and the single-image viewer. It carries two readings side by side, a save-state glyph and a count of the other sessions with the same record open, and its geometry never changes, so nothing in the header shifts as the state does.
The save state is reported with one of six phrases:
Opening the pill shows a Sync Status panel holding the phrase, the time of the last save ("Last saved at 2:41:07 PM"), and a sentence describing presence: "This entry is open in 1 other session." on an entry page, or the equivalent for the patient's records on the Image Pool and full-body pages. The presence count itself is muted while the record is open nowhere else and turns blue as soon as another session appears.
When another session of the same account has an entry, an Image Pool, or a full-body session open, a floating pill appears at the bottom of the dashboard pages. Its label names the surface and the device: "Entry open on a tablet", "Image Pool open on a computer", "Full Body open on Companion", and "3 sessions open elsewhere" once more than one is open. The pill is not shown on the editing pages themselves, and it stays hidden while the connection is not active.
Opening the pill lists those sessions grouped under the patient's name. Each session row repeats the surface and the device and navigates straight into it, which is what turns a chairside capture on a tablet into a write-up on the workstation without a search. Beneath the session rows, the same group offers direct links to the rest of that patient's pages, including Details and Entries, so the pill doubles as a shortcut back to the patient in hand. A dismiss control clears the pill until a new session appears.
Illustrative demo with synthetic data. Learn more
On the editing surfaces themselves, presence is the numeral in the sync pill. The entry page counts the sessions holding that entry, while the Image Pool and full-body pages count the sessions holding that patient's records. The count excludes the current session, so it reads zero while a record is open nowhere else.
Two sessions can hold the same entry open at once, and each one sees the other arrive as the presence count ticks up.
Entry notes and the appointment date are relayed as they are edited and applied to the open entry on the other device, provided that field is not being edited there at that moment and its own save has settled. When either guard does not hold, the relay is dropped rather than overwriting work in progress. Everything else, including the image captions in the workspace, tag assignments, and comparison groups, arrives on the next refresh after the change is written.
Illustrative demo with synthetic data. Learn more
When the same field is changed in two sessions, the conflict is detected and reported rather than applied silently:
Two viewing surfaces hold inbound updates while they are open so that a change arriving mid-review cannot move the image under the pointer. In both cases the pill states the consequence in its presence row while another session is present:
The editing surfaces carry no save button. A caption, a note, an appointment date, or a tag assignment is staged the moment it is made and saved on its own, and the pill runs from Saving to Saved and stamps the time of that save.
Failures are absorbed before they are reported. A change that does not save on the first attempt is retried automatically, and time spent disconnected is not counted against those retries, so a brief network interruption costs nothing. Only once the retries are exhausted on a live connection does the pill read Save Failed. A "Could not save changes" notification is raised at that point, and a Retry Save control appears beside the pill while the refresh control becomes Discard & Reload. Navigating away from a page while changes are still pending raises an unsaved-changes warning first.
Illustrative demo with synthetic data. Learn more
Live Pointer belongs to the same consultation-room workflow: it is the tool for talking through an image rather than editing one. It is armed from the toolbar in the single-image viewer, in both comparison modes, and on the full body and zone review canvases, and it adds a temporary drawing layer over the image: circles and arrows drawn freehand with a mouse, a stylus, or a fingertip fade on their own after a few seconds. Nothing is written to the patient record and the underlying image is never modified, which is what makes the tool safe to use on a screen the patient is watching. While Live Pointer is armed, the overlay takes the pointer, so panning and zooming resume once it is switched off.
Strokes are painted on the display where they are drawn. For markup that belongs to the record and travels with it, use the annotation tools instead, described in Annotating Clinical Images.
Illustrative demo with synthetic data. Learn more
A momentary connection drop shows nothing: Atlas retries briefly before reporting anything, so a short interruption never flashes an error. A sustained loss switches the pill to Offline, and the header shows that changes cannot be saved. A page returning from a background tab or a sleeping device is given a short grace period to re-establish its connection, during which the pill reads Loading rather than Offline.
Reconnection is automatic. Once the connection is restored, the page rejoins the record it has open, presence counts are rebuilt on every device, pending edits are saved, and the page refreshes itself so that anything changed elsewhere during the outage is picked up. Edits made while the connection was down remain staged and keep the unsaved-changes warning armed, so a page holding unsaved work never closes without a warning.
For symptoms that persist, including repeated disconnections, Safari blocking connections on the local network, and sync delays under load, see Troubleshooting Real-Time Sync Issues.
Because sync is scoped to the account, the security of that account governs every device it is signed in on. A password change, a two-factor authentication change, or the Log Out of All Devices action ends every active session across all devices and clears the trusted devices, so each synced session signs in again afterwards. That makes signing out everywhere the reliable way to detach a device that has left the practice. Setup for two-factor authentication, recovery codes, and session management is covered in Account Security: Two-Factor Authentication and Passwords.
Multi-device work is the normal shape of a clinic day rather than an edge case, and synchronization is what keeps it from costing anything. Photographs captured on a tablet are already in the Image Pool when the workstation opens it, an entry started chairside is finished at the desk from the session pill, and no step in that sequence depends on remembering to save. The presence count and the session pill make the second device visible instead of implicit, so a clinician knows before typing whether the record is open elsewhere.
The same design keeps the practice in control of its data. Synchronization runs entirely inside the practice installation, records travel over the practice network, and presence and relayed edits never leave the account that produced them.
Every capability described here is available in Dermi Atlas Professional, the on-premises deployment designed for clinical use. The Dermi Atlas Cloud Demo runs the same sync service on Dermi infrastructure, though some capabilities may be restricted.
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All demonstrations, screenshots, and media on this page use synthetic data only. No real patient information is shown.
The following are synthetic and do not correspond to real patients:
Media is provided solely to illustrate platform functionality and workflows.