When an ultrasound Doc Alert or another clinical document is sent to a physician for review, it shows up in that physician's pending review queue. From there the physician can open the visit, review the details, and sign off with notes and a signature.
Looking for setup (Clinical Reviewer, Doc Alert, Send for Review)? See Doc Alert and Chart Sign-Off: Setup, Review, and Reminders.
Open Approvals. Awaiting Approvals is work assigned to you as a reviewer. Submitted by me is work you sent to someone else. These lists answer different questions; the sender does not need to appear in the physician's reviewer queue.
Doc Alert is the ultrasound review. Other documents keep their own approval-chain names. The general visit provider review is separate.
The queue is the physician's list of charts waiting for their sign-off. Reviewers can also open Home → Pending reviews.
A physician account gets a simplified screen for reviewing: the side menus stay collapsed, and the panel next to a review shows only the review itself instead of donor, task, or other client cards that don't relate to the review.
This simplified view now applies to every physician account, even one still carrying an older staff profile that also grants access to other areas like Donors, Give, or Inbox. You do not need to change that profile for the physician to get the focused review screen.
A physician account also keeps the standard staff navigation, with side menus and other modules available, when it is also set up as a clinic administrator or a WayCool support consultant account. Those two roles need the full menu to manage the organization or troubleshoot it.
A Back to list arrow stays at the top of the review so anyone using the focused reviewer screen can return to the queue without using the browser's own back button.
Some centers are still partway through moving from the previous system to CoolFocus. During that transition, a visit can be sent for physician review from either system:
• Sent from CoolFocus: creates a normal review item in the queue.
• Sent from the older system's "Send to Physician" action: previously this type of send did not appear in the CoolFocus review queue at all. A physician who only worked in CoolFocus could see an empty queue even though visits were waiting for their review in the older system.
The queue includes eligible pending Doc Alerts sent from either version. If a CF3 item is missing, confirm the selected physician and whether it is still pending before sending it again or creating another review.
There is a known sync issue: when a physician signs off an ultrasound in CoolFocus 3, that sign-off does not currently carry over to CoolFocus 5. The Doc Alert stays in the CoolFocus 5 review queue marked as pending, and it can even show as overdue there, even though the physician already reviewed and signed it in CoolFocus 3.
Workaround: until this sync issue is fixed, send ultrasound scans for physician review from CoolFocus 3, not CoolFocus 5, so the send and the sign-off both happen in the same system. Don't try to clear a pending or overdue item in CoolFocus 5 by hand if it was already signed in CoolFocus 3; it will clear on its own once the fix ships.
The review workspace works on a phone, not just a desktop browser.
• Back to the list. On a phone, opening a review used to replace the list with no way to get back except the phone's own back button. A back arrow now sits in the workspace header and returns to the same queue the review was opened from.
• Zoomable scans. Tap an ultrasound image or other attachment to open it full-size with zoom and pan, instead of a small fixed thumbnail that opened in a new browser tab.
• More attachment types preview inline. DICOM scans, video, and audio attachments now open in a real preview instead of showing "Preview unavailable." Images and PDFs continue to preview as before.
If the chart behind a review has already been signed and locked, for example because someone else acted on it, or the same review still shows up after the chart was already approved elsewhere, the review pane makes that state explicit instead of showing empty fields with Approve still on offer.
• An amber banner reads "Chart already signed" and explains that the approval is read-only, with no approval action available for a signed chart.
• Approve, Deny, and Return are no longer offered for a review tied to a signed chart, whether the reviewer acts one at a time or through a batch action on multiple selected reviews. Any such items in a batch selection are skipped rather than acted on.
• This is enforced on the server as well as in the interface, so a signed chart cannot be approved, denied, or returned through a direct request either.
If a chart needs a correction after it was signed, use the addendum flow instead of trying to approve, deny, or return it from the review queue. See Note Locks, Doc Alert Recovery, and Chart Addendums.
The Open full chart link in the review pane opens in a new browser tab, so the review queue stays open in the original tab. For built-in clinical charts (Ultrasound and other chart-based reviews), the link goes straight to that chart on the visit, not just to the visit's Overview tab, so a reviewer lands on the ultrasound images and measurements they were reviewing instead of losing that context.
For a Doc Alert that isn't tied to a separate chart document, this link is labeled Open visit instead of Open full chart, since there is no chart document to open beyond the visit itself.
This link does not appear at all for a physician using the focused reviewer workspace described above, since that view is meant to stay on the review itself.
If approving, denying, or returning a review fails (for example a network issue or a validation problem on the server), the workspace now shows the server's actual error message instead of a generic "Failed to approve" message. This applies to single reviews and to batch actions on multiple selected reviews.
If you have permission, you can reassign a pending review to someone else, or withdraw it, from the review's page in Approvals. Both actions ask for a reason, and both are recorded for compliance; do not include client names or clinical details in the reason.
Reassign a review
• For a Doc Alert (the built-in ultrasound review), choose Reassign review, then pick the new physician directly. There is no reviewer-position option for a Doc Alert. Choosing a new physician updates the physician on the visit and the pending review together, so the visit record and the queue agree on who is reviewing.
• For any other chart review, you can move the review to another named reviewer or to a whole reviewer position.
• Either way, reminders to the current assignee stop and the new reviewer gets one notification. The record stays in review.
Withdraw a review
• Withdrawing a Doc Alert stops the pending review and its reminders. The ultrasound stays on the visit, so staff can make corrections and use Send to Physician again.
• Withdrawing any other chart review stops its reminders, releases the review lock, and leaves the completed chart unsent so it can be sent for review again later.
When a Doc Alert is returned for corrections
If a physician returns a Doc Alert for corrections, its review page in Approvals shows a Corrections requested notice with a link that opens Ultrasound on the visit. Make the requested corrections there, save, then use Send to Physician again from the visit.
A Doc Alert opened from a legacy pending ultrasound still records its physician review on the ultrasound visit. The reviewed state, notes, signature, and date belong to that Doc Alert. They do not mean that every document or other provider review on the visit is finished.
A visit that already has an active review underway (for example, a chart review that hasn't been completed yet) may still be visible in more than one place until that review is finished. This is expected during the transition and does not create a duplicate review; it simply means the visit hasn't been signed off yet.
The Approvals has two separate queues, and they can legitimately show different things at the same time:
• Awaiting Approvals: reviewer-scoped. It only shows charts waiting on you to review.
• Submitted by me: initiator-scoped. It shows charts you sent for review that are still pending someone else's sign-off.
Because the two queues track different roles, a staff member can see an empty Awaiting Approvals list while Submitted by me still shows several charts pending. That is not a bug: it means nothing needs your review right now, but items you submitted are still waiting on their assigned reviewer.
To make that clear in the moment, when Awaiting Approvals is empty and you still have pending items in Submitted by me, the empty state now spells it out and links straight to that queue, for example: "Nothing waiting on you to review. You still have 4 charts waiting on others, see Submitted by me." The bulk selection bar above the list also stays hidden while the list is empty, since there is nothing to select.
• Doc Alert and Chart Sign-Off: Setup, Review, and Reminders
• Visits Overview
• Note Locks, Doc Alert Recovery, and Chart Addendums
