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Week of August 9: side-effect tracking for prescribers

Practices with prescribing enabled can now track medication side effects over time, promote them to the safety list deliberately, and document risk conversations right on the prescription.

New

  • Message your teammates without leaving the app. Messages can now hold conversations with other members of your practice — a quick question for a colleague, a handoff note for the biller, a supervisor check-in — right alongside your client conversations. Everything shows in one list sorted by recent activity, with All / Clients / Team filters if you want just one kind. Team conversations are unmistakable: a purple Internal badge on the list, and a banner above the reply box reminding you the thread is visible to your practice team and never to clients. Starting a message is one search across your team and your clients — team members appear in their own labeled section at the top, and picking someone locks the message to that audience, so a conversation can never mix clients and team members. Teammates get the same new-message email notifications clinicians already get (with an opt-out in their profile), and clients and their portal accounts can never see team conversations.

  • Record side effects without stopping the medication. A new "Report side effect" button on each prescription — and on supplements — captures what the client reported (from a psychiatry-focused list), how much it interferes with daily life, roughly when it started, and the dose at the time. Reports appear as markers on the medication trial timeline and in the prior-authorization trial summary, so "stopped due to side effects" is no longer the only record you have. Recording a side effect never changes the allergy list by itself, and reports can be edited or removed afterward — corrections are status changes, never deletions, so the record stays complete.

  • A full med check without leaving the note. The note's Medications button opens a drawer with two views: New prescription, and Current meds — the client's active medications and supplements, each carrying the med-check actions inline: renew, adjust, record a side effect, or stop. Side effects and stops drop a contemporaneous line into the note itself (stops include the reason and your retrial advice), and prescriptions keep appending the exact prescription line — so the visit note documents the whole med check as it happens.

  • A deliberate path to the safety list. When a reported side effect deserves a permanent place on the client's allergy/intolerance list, a "Promote to safety list" action shows you exactly what will be recorded before you confirm. Entries can later be marked tolerated or entered in error (with a documented reason) — they leave the banner but are never deleted, so the record stays complete.

  • Rechallenge advice on stopped medications. When stopping a medication for side effects, you can note whether the effect was dose-related and whether a retrial would be reasonable (at a lower dose, with support, or best avoided). If you ever prescribe that medication again, the warning shows your prior note — guidance from your past self, right when it matters.

  • "Risks discussed" on the prescription. A checkbox group at prescribing records which risks you discussed with the client (movement symptoms, metabolic effects, sedation, sexual side effects, discontinuation symptoms, or your own wording). It is stored on the prescription itself and echoed in the visit note's "Medications prescribed this visit" line — contemporaneous documentation with one click.

  • Review your last treatment plan and diagnoses together. On the Diagnosis page, a new "Review last plan" button opens your client's most recent treatment plan with the current diagnoses right above it — edit either one, and a single save records the diagnoses as a new dated entry and creates a new version of the plan (the previous version is kept as history). You land on the new version with Sign ready, so the periodic plan review — re-affirm the diagnosis, refresh the goals, re-sign — is now one page instead of three.

  • Send scored measures to many clients at once. The Share documents wizard (Clients → Share documents) now includes your enabled scored measures alongside consent forms and questionnaires — send a one-time measure to your whole caseload in one pass instead of opening every chart. Recurring schedules are still set up from the individual client's chart, where you can tailor the cadence to each person.

  • Interoceptive awareness tracking for body-centered work. The MAIA-2 — the standard research instrument for interoceptive awareness, from UCSF's Osher Center — is now in the measures library with all eight subscales scored automatically (Noticing, Not-Distracting, Not-Worrying, Attention Regulation, Emotional Awareness, Self-Regulation, Body Listening, and Trusting). Built for somatic and mind-body practitioners tracking how a client's relationship with their body changes over the course of treatment. Enable it under Settings → Scored measures.

  • Physical-symptom tracking joins the measures library. The PHQ-15 — the somatic-symptom companion to the PHQ-9 — is now available with automatic scoring against its published severity levels. Useful for tracking headaches, pain, GI distress, fatigue, and other physical symptoms alongside mood and anxiety, especially in body-centered work. Enable it under Settings → Scored measures.

  • Adult ADHD screening joins the measures library. The ASRS v1.1 screener (the WHO 6-question adult ADHD screen) is now available alongside PHQ-9, GAD-7, and the rest — with automatic scoring against the published cutoff. It's a screening tool for ages 18 and up: enable it under Settings → Scored measures and send it once at intake or whenever ADHD is in question; a positive result suggests a full clinical evaluation.

Improved

  • Your website's menu can now link to your own sections. Each content block in the website builder has a "Show in top menu" option — turn it on and that section appears in your site's top navigation (with a short label of your choosing, like "Services" or "FAQ"), ahead of the built-in Locations and Contact links. Nothing changes unless you opt a section in.

  • Client Portal moved front and center on practice websites. The hero section now shows a Client Portal button alongside Request an Appointment (portal first), and the portal button no longer crowds the site header. Republish your site from Settings → Website to pick up the new layout.

  • You now hear about it when an existing client uses your public booking form. For privacy, the public "request an appointment" form never tells the person filling it out whether an email address already belongs to a client of your practice — it quietly emails that client a link to sign in to their portal instead. Now your practice gets an email too, naming the client and what they tried to book, so you can reach out and make sure the appointment actually gets scheduled. The booking form also says much more clearly — up front, at the contact step, and on the confirmation screen — that existing clients should sign in to the portal to request appointments.

  • Attach a lab report PDF and let the app read the values for you. When entering lab results, attach the source PDF and click "Read values from report" — matching tests are filled in for you, each marked "from report" until you confirm it. Nothing saves until you check "I verified these values against the report," a value in an unexpected unit is never filled in automatically, and anything the reader isn't certain about is listed for manual entry instead. The collection date — and time, when the report prints one — fill in too.

  • Lab results can record the time collected. When entering lab results, an optional "Time collected" box sits next to the collection date — useful when timing changes what a number means, like a lithium trough drawn ~12 hours after the last dose or a morning testosterone. The time shows when you hover the result in the lab flowsheet, and results entered without a time work exactly as before.

  • Lab trends show the dose at each draw. The lab trend chart now carries the "medication dose at draw" recorded with each result — hover any point to see it, and when the regimen changed between draws, an annotation under the chart lists what changed and when. A level that moved with a dose change reads differently from one that moved without.

  • Staff team members land on the right page at sign-in. Billers, schedulers, and practice managers no longer start in the clinician tutorial about recording sessions. Billers land on the Billing dashboard; schedulers and practice managers land on the calendar.

  • Welcome emails now match the new team member's role. When you invite a biller, scheduler, or practice manager, their welcome email orients them to the parts of the app they'll actually use — billing, the practice calendar, or team settings — instead of clinician instructions about writing session notes. Combined roles get a bullet for each.

  • A cleaner Diagnosis page. When a client has a treatment plan, the page now opens with a banner pointing to "Review last plan" (and asks before leaving if you've typed codes you haven't saved). After saving diagnoses for a client who already has a plan, the next step offered is reviewing that plan — not accidentally starting a second one, though "Start a new plan instead" is there when you mean it. The old "Load last plan" button is now "Load last diagnoses" and appears only for clients who don't have a plan yet. And editing a diagnosis from the client's timeline is now clearly labeled as correcting that dated entry — the fix applies to sessions billed in its period — with a pointer to "Review last plan" when what you actually want is to change the diagnosis going forward.

  • The pending-forms reminder on a client's profile can be dismissed. The "oldest pending form was assigned N days ago" note now has an ✕ — dismissing it remembers your choice for that batch of forms and returns only if newer forms go stale. And when a form from an intake couldn't be assigned, the warning now carries a Re-send button that opens the intake wizard directly.

  • Add a session to an insurance payment you already recorded. Editing an insurance payment now lists all of that payer's appointments — the ones already on the payment plus any others with claims or unbilled sessions — so if part of a check couldn't be matched up at first (a missing claim, a session that wasn't visible yet), you can fix the issue and allocate the remainder to the same payment instead of deleting and re-entering it. Sessions without a claim get one created automatically when you save, marked as filed outside the app.

  • Billing dashboard numbers now say what period they cover. The Invoices Sent and Payments Received tiles are labeled "(selected range)" and both follow your date filter (Invoices Sent previously counted all time). The CSV export now contains exactly the rows you see on screen for the selected range, and clearing the date filter now genuinely shows all time everywhere on the page.

  • Old outstanding claims can't hide behind the date filter. The Claims tab shows the last 12 months by default; if you have outstanding claims older than your selected dates, a notice now tells you how many and offers one click to show them.

  • The Filed Claims report has a date filter. Opening it from the analytics "Claims filed" card carries your selected period over, so the report matches the card's count — and you can adjust the dates on the report itself.

Fixed

  • Insurance status shows on the billing list even when the client owes $0. For clients with no copay (common with Medicaid), sessions have no client invoice — and the client's Billing tab used to show those sessions with blank insurance columns even after the claim was paid. The list now finds the claim from the session itself, so insurance paid and write-off amounts appear whether or not an invoice exists.

  • A claim created but never submitted no longer gets stuck. If you created a claim without submitting it (because you file with that payer outside the app), it could end up invisible to the Add Insurance Payment screen — with no way to record the payment. Draft claims now have a "Mark as Filed Externally" button, and while a claim is awaiting its payment the billing page shows the insurance portion as pending instead of displaying the whole fee as a "write-off" you never entered.

  • The Billing page now shows payouts for the dates you pick. The payouts list on the Billing page (in both the Payouts and Card Transactions views) used to show only your ten most recent bank payouts no matter what date range you selected — older payouts looked like they were missing, even though the money had arrived. The list now follows your date filter, so you can look back as far as you need. Payouts still on their way to your bank remain visible.

  • Billing lists no longer stop at a hidden cutoff. Several billing views quietly showed only the most recent records once a client or practice had enough history: the Collect Payment window could miss older unpaid invoices (even though the balance beside them was right), the Create Invoice window could hide older unbilled sessions — or re-offer a session that was already invoiced — an insurance payment's adjustments could disappear from its detail page, and a payout's transaction breakdown stopped at 100 items (its dates also showed as "-"). All of these now load the complete history.

  • Diagnoses on a Simple treatment plan are shown, not re-typed. The Simple treatment plan form used to let you edit diagnosis codes right on the plan, and a code changed there could fall out of sync with the diagnosis list your claims and superbills draw from. The plan now displays the diagnoses it addresses, with an "Edit diagnoses" link to the Diagnosis page — the one place diagnoses are edited — so the chart, the plan, and your billing documents always agree.

  • Billers, schedulers, and practice managers are no longer asked for clinical credentials. Team members without a clinician role used to see a "Complete Profile" prompt in the header asking for an NPI, license, and specialty code they'll never have. That prompt now appears only for clinicians; staff profiles show their actual role.

  • Uploading .m4a session recordings works again. The audio upload page rejected .m4a files (the format iPhones and many recorder apps produce) because of how browsers label that file type. All common audio formats — m4a, mp3, wav, webm, ogg — now upload reliably, even when the browser doesn't report a file type at all.