> ## Documentation Index
> Fetch the complete documentation index at: https://docs.encoreos.io/llms.txt
> Use this file to discover all available pages before exploring further.

# Clinical In-Basket User Guide

> This guide helps clinicians and clinical staff use the In-Basket to manage actionable clinical items such as lab results, prescription renewals, co-sign reques…

> **Purpose:** This guide helps clinicians and clinical staff use the In-Basket to manage actionable clinical items such as lab results, prescription renewals, co-sign requests, and chart messages.

***

## Overview

The Clinical In-Basket is a centralized inbox for clinical action items. It consolidates tasks from multiple sources — lab results, prescription renewal requests, referral responses, co-sign requests, CDS alerts, and chart messages — into a single, filterable list so providers can prioritize and act efficiently.

### Key Capabilities

* **Unified clinical inbox:** All actionable items in one place, sorted by priority and due date
* **Filtering and classification:** Filter by item type, classification (clinical/administrative/billing/regulatory), and status
* **Status management:** Track items from new → in progress → completed with a full activity audit trail
* **Escalation:** Escalate items to `stat` priority when urgent attention is needed
* **PM-14 deep-links:** Chart messages link directly to the secure messaging conversation

### Who Should Use This Guide

| Role                  | Use Case                                                    |
| --------------------- | ----------------------------------------------------------- |
| Licensed Clinician    | Review lab results, co-sign requests, prescription renewals |
| Clinical Supervisor   | Monitor team in-basket items, co-sign pending documents     |
| Nurse                 | Triage incoming lab results and system alerts               |
| Prescriber (MD/NP/PA) | Handle prescription renewals, PDMP alerts                   |

***

## Prerequisites

### Permissions Required

To use the Clinical In-Basket, you need:

| Permission             | Description                       |
| ---------------------- | --------------------------------- |
| `cl.inbasket.view`     | View in-basket items              |
| `cl.inbasket.manage`   | Update status and manage items    |
| `cl.inbasket.assign`   | Reassign items to other providers |
| `cl.inbasket.escalate` | Escalate item priority to stat    |

> **Note:** Contact your organization administrator if you don't have the required permissions.

***

## Getting Started

### Accessing the In-Basket

1. Navigate to **Clinical** in the main menu
2. Click **In-Basket**
3. The list page displays all items assigned to you or your team

### Understanding the Interface

| Element         | Description                                                |
| --------------- | ---------------------------------------------------------- |
| Filter bar      | Filter by item type, classification, and status            |
| Item list       | Table of in-basket items with priority badges              |
| Priority badges | **Stat** (red), **Urgent** (yellow), **Routine** (default) |
| Status badges   | New, Read, In Progress, Pending, Completed, Cancelled      |

***

## Common Tasks

### Task 1: Review and Triage Items

**When to use:** At the start of your shift or when new items arrive.

**Steps:**

1. Open the **In-Basket** page
2. Items are sorted by priority (stat first) and due date
3. Use the **Type** filter to focus on specific categories (e.g., Lab Results only)
4. Click on an item row to open the detail view

**Tips:**

* Use the **Status** filter set to "New" to see unreviewed items
* Stat items appear with a red badge — address these first

***

### Task 2: Update Item Status

**When to use:** After reviewing or acting on an in-basket item.

**Steps:**

1. Open the item detail page
2. Click the **Status** dropdown
3. Select the appropriate status:
   * **In Progress** — You are actively working on this
   * **Pending** — Waiting on external information
   * **Completed** — Action fully resolved
   * **Cancelled** — Item no longer relevant
4. The status change is saved automatically and logged in the activity timeline

> **Note:** All status changes are recorded with your name and timestamp in the activity log.

***

### Task 3: Escalate an Item

**When to use:** When an item requires immediate attention beyond its current priority.

**Steps:**

1. Open the item detail page
2. Click the **Escalate** button (requires `cl.inbasket.escalate` permission)
3. The item priority is changed to **Stat** and an escalation activity is logged

> **Warning:** Escalation should be reserved for genuinely urgent situations. All escalations are audited.

***

### Task 4: View Activity History

**When to use:** To understand what actions have been taken on an item.

**Steps:**

1. Open the item detail page
2. Scroll to the **Activity Timeline** section
3. Activities are shown chronologically with actor, type, and timestamp

***

### Task 5: Access a Chart Message Conversation

**When to use:** When a `chart_message` item links to a PM-14 secure messaging conversation.

**Steps:**

1. Open the chart message item detail
2. If a linked conversation exists, a **View Conversation** link appears
3. Click the link to navigate to the secure messaging thread

***

## Tips and Best Practices

### Do's

* ✅ Review your in-basket at the start and end of each clinical shift
* ✅ Use filters to focus on high-priority or specific item types
* ✅ Update item status promptly to keep your team informed
* ✅ Escalate genuinely urgent items — the audit trail protects appropriate use

### Don'ts

* ❌ Don't leave stat items unaddressed for extended periods
* ❌ Don't use escalation for routine items
* ❌ Don't mark items as completed without taking the required action

***

## Troubleshooting

### Common Issues

#### Issue: No items appearing in the In-Basket

**Symptoms:** The In-Basket list shows an empty state.

**Cause:** No items are assigned to you, or filters are too restrictive.

**Solution:**

1. Clear all filters to see all items
2. Confirm your user account has the `cl.inbasket.view` permission
3. Contact your administrator if items should be present

***

#### Issue: Cannot change item status

**Symptoms:** Status dropdown is disabled or changes fail.

**Cause:** You may lack the `cl.inbasket.manage` permission.

**Solution:**

1. Confirm you have the `cl.inbasket.manage` permission
2. Contact your organization administrator to request access

***

### Getting Help

If you can't resolve an issue:

1. Check with your clinical supervisor
2. Contact your organization administrator
3. Review the specification for technical details

***

## Related Documentation

* **Specification:** `specs/cl/specs/CL-23-clinical-in-basket-provider-messaging.md`
* **Integration:** `docs/architecture/integrations/CL-23-clinical-in-basket-provider-messaging-INTEGRATION.md`
* **Related Features:** CL-04 (Progress Notes), CL-09 (Lab Orders), PM-14 (Secure Messaging)

***

## Glossary

| Term              | Definition                                                                 |
| ----------------- | -------------------------------------------------------------------------- |
| In-Basket         | A centralized inbox for clinical action items requiring provider attention |
| Stat              | Highest priority level indicating immediate action required                |
| Escalation        | The act of raising an item's priority to stat                              |
| Co-sign           | Supervisory review and signature on a clinical document                    |
| Activity Timeline | Chronological audit log of all actions taken on an item                    |

***

**Last Updated:** 2026-02-25\
**Questions?** Contact your organization administrator.