"I can only export one letter after the first couple of patients"
Fix for "I can only export one letter after the first couple of patients" in the Akuru extension: use the Insert Outputs flow into Xestro instead of Send to EMR.
If you can get one letter into Xestro but a second letter won't go in, and it seems to start happening after the first couple of patients, you're almost certainly hitting the Send to EMR path. The reliable fix is to use Insert Outputs instead, which lets you place each letter into a fresh Xestro letter, one at a time.
The fix in one line: for letters, use Insert Outputs (the toolbar dropdown) rather than the Send to EMR button on the output card. Create a new letter in Xestro, click inside it, then Insert Outputs and pick the letter. Repeat for each letter.
Why this happens
The extension has two ways to get an output into the EMR:
- Send to EMR is the button on each i-scribe output card. For letters it tries to open Xestro's Quick Letter editor and drop the body in for you. This is the path that can fail when you need more than one letter.
- Insert Outputs is the toolbar dropdown. It inserts the output into whatever field you last clicked, so you decide exactly where each letter lands. This path is reliable and repeatable per letter.
The "Send to EMR into Xestro's letter editor can fail" behaviour is a known limitation we're actively working on (Jira INTG-129).
We haven't yet confirmed whether the specific "only one letter after a few patients" symptom is exactly the same root cause as INTG-129 or a separate issue. [VERIFY] Either way, the Insert Outputs flow below is the recommended fix.
The fix: use the Insert Outputs flow
Do this once per letter. The key step is that you must click inside the blank letter first. That's how the extension knows where to put the output.
In Xestro, Create New Letter so you have a blank letter open.
Click inside the blank letter body so your cursor is in it.
In the Akuru toolbar, open Insert Outputs.
Pick the letter you want (for example, GP Letter).
To add another letter (for example, Patient Letter), create another new letter, click inside it, open Insert Outputs again, and pick that letter.
This is the same flow described in Insert a letter into the Xestro letter editor. The difference here is the troubleshooting context: if "Send to EMR" gave you only one letter, switching to Insert Outputs is the answer.
Why Insert Outputs is reliable
Because Insert Outputs targets the field you last clicked, each letter goes exactly where you put your cursor. Create a new letter, click in it, insert, and repeat. There's no shared editor state that can get stuck after the first letter, which is what makes it dependable across many patients in a session.
Which outputs can I insert this way?
Any of your i-scribe outputs: Medical Note, GP Letter, Patient Letter, Referral Letter, and Optometrist Letter. The toolbar dropdown lists whatever's ready.
Do I still need to confirm the patient?
Yes. The patient name-match safety check runs before every insert. If you see an amber mismatch warning, see "No patient loaded" and patient name mismatch warnings.
My note goes in fine but letters don't. Is that normal?
Notes and letters route differently with "Send to EMR" (the note goes to the clinical notes, letters to the letter editor). If letters specifically are the problem, use the Insert Outputs flow above for them.
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