Patient Record: Clinical Tab

Where visual clinical documentation lives

Most of a patient record is text: notes, forms, dates, amounts. The Clinical tab is different — it's where anything that needs to be drawn, marked up, or visually reviewed lives. That covers two distinct tools: the Body Chart Annotator, for marking findings directly on a diagram of the body, and, for clinics that work with medical imaging, a full DICOM Viewer for reviewing and measuring scans. Both open as full-featured editors with their own toolbars, layered over the rest of the patient record rather than replacing it.

These two tools solve different problems and are built differently under the hood, which is why they behave differently in a few important ways covered later in this article — most notably, one of them autosaves and one of them does not. Knowing which is which before you start annotating something clinically important is worth the two minutes it takes to read this article once.

The Clinical tab of a patient record showing a body chart thumbnail and a DICOM imaging thumbnail strip side by side.

Body Chart Annotator

Body charts exist because some clinical findings are much faster and clearer to draw than to describe. A physiotherapist marking areas of restricted movement, a dermatologist tracking a set of lesions across visits, or a dentist noting which teeth need attention are all better served by a marked-up diagram than a paragraph of prose trying to describe the same thing in words. Because the same annotated chart can be reopened at a later visit, it also becomes a simple way to track how a finding changes over time — is the marked area shrinking, spreading, or resolved — without relying on memory or a written description to make that comparison.

The annotator you reach from this tab is not unique to the Clinical tab — it's the same tool used anywhere a body chart field appears, including in patient forms and in custom patient fields. Learning it once here means you already know it wherever else it turns up in ClinyPal.

Opening a chart and picking a template

The templates available in this gallery are managed separately, so the exact set you see depends on what your clinic (or ClinyPal) has made available.

The body diagram template gallery, showing a grid of selectable body chart templates before entering the annotator.

The tool palette in detail

The Body Chart Annotator open on a body diagram, showing the tool palette with Pen, Eraser, Text, and Hand tools, the 6 color swatches, and the stroke-width slider.

A common workflow is to use color deliberately rather than decoratively — for example, reserving one swatch for active findings and another for resolved or historical ones, so a chart annotated across several visits stays readable at a glance instead of turning into a single tangle of identical marks. The stroke-width slider is useful for the same reason: a thin stroke for fine detail work, a thick one for broadly circling a region.

• Mouse wheel zooms in and out on the chart.
• On touch devices, pinch to zoom.
• Undo and Redo support up to 50 steps of history, so you can recover from a misplaced stroke or an accidental Clear all before you've saved.

Saving — the one behavior to get right

Of everything in this article, this is the detail most worth internalizing: the Body Chart Annotator has no autosave of any kind. Every annotation you make exists only in that editing session until you explicitly save it.

In practice, this means treating an in-progress annotation the way you'd treat an unsaved document anywhere else — if you get interrupted mid-annotation, it's worth finishing the thought and saving before switching away, rather than assuming you can pick it back up later exactly where you left off.

DICOM Viewer

For clinics that receive or generate medical imaging — X-rays, CT series, MRI studies — the DICOM Viewer brings scan review directly into the patient record instead of requiring a separate PACS workstation. It's a genuinely full-featured imaging tool: navigation, a full measurement suite, image transforms, and region-tuned display presets, all accessible without leaving ClinyPal.

Because it's built for real diagnostic and treatment-planning workflows rather than as a lightweight preview, the measurement and annotation tools here are not decorative — a Cobb angle measurement or an HU probe reading taken in this viewer is meant to be clinically usable, which is also why (unlike the body chart annotator) this viewer's annotations and measurements are actually persisted, covered below.

The DICOM Viewer open on a scan, showing the toolbar, thumbnail strip on the side, and a status bar at the bottom with active tool, zoom percentage, and frame number.

Toolbar groups

The Measure group is the one most worth knowing in full, since it's where clinical value is captured directly in the record: Length and Bidirectional for linear measurements, Angle and Cobb angle for angular ones (Cobb angle specifically for spinal curvature), Ellipse ROI and Rectangle ROI for region-of-interest measurements, an HU probe for a Hounsfield unit reading at a point, and Arrow for simply pointing something out without measuring it.

Getting the contrast right: window/level presets

Different tissue types are best viewed with different window/level settings — bone detail and lung detail on the same CT slice, for instance, are essentially invisible to each other under the same contrast settings. Rather than manually tuning window and level by dragging with the middle mouse button every time, a Presets dropdown applies settings tuned for a specific body region in one click:

• <strong>Chest</strong>
• <strong>Lung</strong>
• <strong>Abdomen</strong>
• <strong>Bone</strong>
• <strong>Brain</strong>
• <strong>Stroke</strong>
• <strong>Subdural</strong>
• <strong>Spine</strong>
• <strong>Liver</strong>
• <strong>Angio</strong>
• <strong>Auto</strong> — a reasonable default when you're not sure which named preset fits the study

A practical habit: apply the closest-matching preset first, then fine-tune manually with a middle-drag if the study needs it. Starting from a tuned baseline is faster than dragging from scratch, and it also means anyone else who opens the same image later can apply the same preset and see roughly the same thing you did.

Mouse mapping while you work

Right- and middle-drag are always mapped to Zoom and Window/Level respectively, regardless of which tool is active on the left mouse button — so you can be mid-measurement with the Length tool selected and still zoom or adjust contrast without switching tools first. This is what makes the viewer usable one-handed for quick review, and it's worth knowing even if you only ever use the left-click tools directly.

Working across multiple images

A patient's imaging history often isn't a single file — it's a growing collection of studies taken over time, sometimes from different modalities. The viewer is built around that reality rather than a one-image-at-a-time assumption.

• A <strong>thumbnail strip</strong> lists all images and series loaded for the patient, so you can jump between studies without leaving the viewer.
• Drag and drop files directly onto the viewer to upload new images into the patient's imaging history.
• A side-by-side <strong>A/B compare mode</strong> lets you view two images at once — useful for comparing a follow-up scan against a baseline without flipping back and forth.
• A <strong>scrubber bar</strong> lets you step through frames of a multi-frame series, such as a CT stack, one slice at a time.

How saving works here — and why it's different from body charts

Unlike the Body Chart Annotator, the DICOM Viewer's annotations and measurements are treated as part of the clinical record, not a throwaway markup layer — so they're actually persisted rather than read-only or session-only.

This asymmetry with the Body Chart Annotator is intentional, not an inconsistency to work around: a body chart is a quick, iterative sketchpad you might redraw several times before it's worth keeping, while imaging measurements represent a specific, often clinically load-bearing reading you'd rarely want to lose to an accidental close.

Staying oriented: the status bar

A status bar at the bottom of the viewer keeps you oriented while you work, showing the active tool, current zoom percentage, window/level values, the Hounsfield unit (HU) value under the cursor, and the current frame number. Glancing here is a quick way to confirm you're looking at the setting you think you are before taking a measurement that will be saved to the record.

Frequently asked questions