Notes on Spruce let providers document important information without exposing it to the patient. There are two types: internal notes that live inside a specific patient conversation, and Note Conversations that appear in the Notes filter and in the relevant Contact Card conversation sections. Both types are private to the team and never visible to the patient. Internal notes can be posted, scheduled, or set as the default reply mode. Note Conversations can reference one patient, multiple patients, or no patient at all (personal-only). They can be created from the Inbox or from a Contact Card, shared with specific teammates, and managed with options including delete, star, archive, add tags, and adjust member access.
IN THIS ARTICLE
Internal Notes
Spruce internal notes are like “sticky notes” on a patient chart, but exist within patient conversations in Spruce. They are only visible to you and your teammates; patients cannot see internal notes. Internal notes are often used for clinical note taking, assigning tasks, or paging yourself or teammates to create a reminder or to draw attention to a message.
Internal notes are differentiated from patient-facing messages in the Spruce conversation in a couple of ways:
| Internal Notes | Patient-Facing Messages |
| When you're in a patient conversation, you'll select Internal from the compose bar. You will see a yellow background, and the button in the bottom right will read Post. | When you're in a patient conversation, you'll select the message channel (secure messaging or SMS) from the compose bar. You will see a white background, and the button in the bottom-right will read Send. |
| Once posted, you'll see a yellow background and Internal Note within the message. | Once sent, you'll see a white background. |
Posting an internal note
Open a patient conversation. In the compose bar, select Internal. The background will be yellow. Compose your note and select Post. Once you have posted the internal message, you will see a yellow background and the word Internal Note to indicate that it's not being sent to the patient.
Scheduling internal notes
Just like with patient-facing messages, you can schedule internal notes to post at a later time to serve as a reminder to yourself or your teammates. To schedule an internal message, begin by composing the message, then select the Calendar Icon at the bottom of the compose bar. Toggle on (blue) Schedule Message Delivery, and set a date and time for the message to be delivered. Then select send.
Click into the scheduled message at any time to delete it and cancel the delivery.
Default to internal notes
Defaulting to internal notes is a good practice that prevents you from accidentally sending an internal comment to a patient. This means that you'll automatically be set to Internal Notes when composing a message and you'll need to toggle to "SMS or Secure Message" to send a message to your patients.
You can set internal notes as the default setting for your compose bar. To change this, select the Gear Icon to open your Settings, then select My Preferences on mobile or Personal Preferences on web and then toggle Default to Internal Notes ON (blue) or OFF (white).
Note Conversations
Spruce also has a "Notes" feature that is separate from a patient conversation. These are helpful if you would like to take a lot of notes regarding a patient, if your notes aren't specific to any one conversation, and if you don't want to scroll or search for a particular note you made. Again, they are only visible to you and your teammates; patients cannot see your notes.
This article covers some ways that this feature may be useful to your practice.
Creating a Note Conversation From Your Inbox
- From your Inbox, tap the + icon and select “Note”.
- You may enter a contact if it is regarding a patient or colleague, or simply enter a subject and corresponding message if it’s for your view only.
- Tap the yellow “up arrow” (on your phone) or “Post” button (on the web) to save it.
Now, go to your Notes filter, which you can find by clicking on the "down arrow" next to "Inbox" on your mobile screen or selecting "Notes" on your web sidebar, and you will see that note you just created.
If your note is regarding a patient, you may also select that patient's contact, and see any notes regarding them under "Conversations."
You may choose to later delete it, star it, or archive it by swiping the note to the left and choosing from the options that appear on the right on your mobile device. On the web, you can hover over a note, select the three vertical dots that appear to see a menu of options.
These are your notes, but you may provide access rights to your colleagues if you’d like for them to see them. To do this, click into any note, select the "i" icon in the upper right-hand corner and choose to "Edit" the members on web. Members will have access to the specific note.
Creating a Note Conversation From a Contact Card
A note may be created within a Contact Card if it is specific to a patient.
- Select any patient contact.
- Select the Note icon.
- You'll notice that the “regarding” line will be in the name of the patient in that contact card.
The rest of the process is the same as what is outlined above, only when you save it, it will appear in both the Conversations section of that contact card and within a high-level Notes filter.
These are your notes, but you may provide access rights to your colleagues if you’d like for them to see them. To do this, click into any note, select the "i" icon in the upper right-hand corner and choose to "Edit" the members on web. Members will have access to the specific note.
You may add one or more contacts to the "Regarding" section of a Note to have the Note show up within the Conversations section on multiple Contact Cards. That said, Notes do not need to be regarding any contact at all. You may write a secure Note just for your view and/or add members of your team if you’d like for them to access the note as well.
Helpful Hints
Select the “i” icon for “Conversation Details” within any note to:
- Edit the Members who can access the Note.
- Edit the “Subject” of the Note (we recommend standardizing naming the note with the date to help you find your notes more easily).
- Change Assignment / Archive (Filter will display “Unarchived” notes).
- Add Conversation tags.
- Update the “Regarding” section to associate the note to no one, to a single contact, or to multiple contacts.
- Assign the Note to another team member by using @Page, but be sure to include the team member in the “Members” section of the Note as well, so they have complete access to the Note.
- Delete the note.
Frequently Asked Questions
What is the difference between internal notes and Note Conversations on Spruce?
Internal notes live inside a specific patient conversation, while Note Conversations appear in the Notes filter and in the relevant Contact Card and can reference one patient, multiple patients, or no patient at all.
Can patients see notes posted on Spruce?
No, both internal notes and Note Conversations are not visible to the patient.
Can a Spruce note be scheduled?
Yes, internal notes can be scheduled to post at a future time. Note Conversations support management options including delete, star, archive, add tags, and adjust member access.