creating PDF

[cverk]

I was having a dialog regarding this issue on the other forum and then I ran across this area which seemed the right place. I think it would be a good code request to have the report area have the option of creating either a html screen or a pdf file to print/save, similar to the option for growth charts under vitals. PDF is the standard for transfering documents and you should be able to produce a pdf of all the patient data including attached documents when you generate a report. The use of internet fax and telephone solutions seems to be up and coming, and utilizing those will bring incoming and outgoing faxed documents as pdf attachments which can help eliminate a lot of office paper use. I think this would substantially improve usability for windows users by eliminating the need for linux friendly programs that have to be configured like hylafax,imagemagick,emailservers etc. The closer to plug and play you can get, the more people I think you will get interested.

[tmccormick]

OpenEMR supports the creation of PDF using easypdf libraries. Some reports and printout already support them. Most do not. I posted a proposed spec on the wiki a long time ago that recommended all reports be available in HtML, PDF and CSV downloads as a standard.

For now, most systems support "Print to PDF" as a normal "printer". This is a default for Linux OS, for window you can install PDFCreator and you can print to it, producing a very nice PDF of anything.

--Tony

[Aethelwulffe]

There are many ways to handle this, yes, including some code support in the EMR and other utilities. Ideally, the EMR should produce the pdf for download or transmission, though CCR and other comm methods are a higher priority for development since so many other options are available, but this should be an item earmarked for Practice Management dev. Obviously, an include function that communicates with the easypdf libraries with a standardized interface is the preferred methodology.
Cverk, let's look to how we want to think about this. It's both a "modular version" issue, a "reports development" issue, and a "Practice Management" issue.
I would personally push for this as a modular version dev issue. We would need to get the export include made up, then convert the forms to use it. Another option is to include a main header frame link to the utility to turn any existing in-focus frame into a pdf (pdf top/pdf bottom). This is probably the best option.

[cverk]

Print to PDF is pretty easy to configure, except that the imagemagick conversion of multipage pdf documents makes for long jpg files, under windows at least, that only allow printing of the first page. So there is no integrated way to make a single PDF of a given patients records to send anywhere for care coordination. I developed a workaround for now,but it is not elegant. You can print to pdf everything but documents under report. You can copy each individual PDF either from the documents page or out of the directory itself. I can then put them all into paperport that I use for my scanner and use paperport to stack them into a single file.
Again this does not seem like the kind of solution needed for what seems to me to be a pretty basic functional need. I am not a programmer, but it seems like the ezpdf thing is already integrated to make a pdf out of the growth chart in vitals. Couldn't that same basic coding be extended to make similar buttons for either html or pdf creation in reports as well?

[cverk]

Maybe I haven't been clear about how I am using document import in my workflow. I receive patient information from multiple sources including mail, courier,fax, and now fax to e-mail. I can scan all paper documents to pdf to enter into the documents section of openemr, and fax to e-mail also comes as attached pdf files which also can be imported into documents. I then produce visit notes, and an expanding database of things like medication lists. I have elected to make a seperate file of old paper records outside the database scanned in pdf format.
So for example today we had a request for records on a patient who had moved, that were combined into a 630 page pdf and burned to CD for transfer to her next care provider. Printing and mailing that type of file would be kind of ridiculous, so it seems like it would be nice to be able to combine it all together into a pdf through openemr.

[Aethelwulffe]

Have you tried the CCR record export? You can simply export a patient's record (including documents) to a "web page-complete" format. Then the data can be converted or at least copied and pasted for transposing certain bits like demographics if they cannot use something more like an import. That is far better than an image pdf to my mind.
To get that, simply right click in the frame of the report, select "this frame/save this frame as:" then select "web page complete". The folks on the other side can see what you see when they open the html file. HTML is MUCH more useful and much >smaller<.

[cverk]

That approach does allow you to save the file as an html file, but it doesn't fix the issue I was trying to point out. If you have a multipage pdf document as an attachment, only the first page of that is available to print, either to paper or using print to pdf. That appears to be because imagemagick makes a long jpg file out of multipage PDF files without page breaks. So it doesn't allow you to create a document containing all of a patients records for transfer to another provider in a usable format such as pdf.

[drbowen]

The CCR should be exporting all the files from the documents as the intact pdfs. The goal of the CCR / CCDs is to allow the receiving medial practice to import the CCR / CCD into their certified EHR. This should import demographics and other discrete data including laboratories. Eventually this will include x-ray reports, hospital H&Ps, discharge summaries, consult notes and other defined data types. Trying to roll-your-own will long term cause you to be swimming up an ever more powerful stream.

Not sure about how image magick handles the pdfs but I know that image magick doesn't do this this very well. In my practice I normally handle out outgoing charts through the report section and the resulting printing is poor. I believe image magick is converting the pdfs to jpgs as you describe but at a 200 dpi resolution. I would like the report section to handle this better but it has been behind a long list of priorities. I have to confess I haven't worked with the new CCR myself but generating this CCR is supposed to be able to do exactly what you describe and then just burn it to a CD. Using the new HIEs allow you to transfer very large files more easily than email. Garden State Health Systems has this type of HIE if you are interested in checking this out. Certainly for now burning to CDs is the easiest solution.

Sam Bowen, MD