Xestro is the Akuru browser extension's **first dedicated EMR integration**. That means it isn't just "supported". It gets the complete set of features, built and tested specifically against Xestro's screens: pre-fill from the EMR, smart routing of outputs back into the right place, patient-name safety checks on every transfer, and one-click appointment sync to i-consult.

This page is the map. It explains what makes the Xestro integration different and points you to the step-by-step guides for each task.

```callout kind="info"
**Before you start**, make sure:

- The Akuru browser extension is installed and pinned in **Google Chrome** (or a Chromium-based browser). Edge, Safari and mobile are not supported, so use Chrome.
- Xestro and i-scribe are open **side by side in the same browser window**, not in separate windows. The extension passes data between the two tabs, and that only works inside one window. Keep Xestro to a **single active tab**.
```

## What makes the Xestro integration "dedicated"

Xestro is the EMR the extension is built around today: it understands the actual Xestro screens, so it can read the patient record, place a note or letter in the correct field, and sweep your day's appointments. (Support for more web-based EMRs is coming soon.) The four pillars:

```steps
1. **Pre-fill.** Click **New Patient** in the Akuru toolbar and the extension reads the patient open in Xestro (name, date of birth, and the clinical background from the right-hand detail boxes) and loads it into i-scribe as context. You stay on Xestro.
2. **Smart routing of outputs.** Once outputs are generated, the extension knows where each type belongs in Xestro: a medical note goes to the clinical notes, a letter goes into the letter editor.
3. **Patient-safety name matching.** Before any transfer, the extension checks the patient in Xestro matches the patient in i-scribe, and stops if they don't.
4. **Appointment sync to i-consult.** Sweep the next 1 to 14 days of Xestro appointments and send them to i-consult in one click.
```

```image media="11" caption="The Akuru top bar over a Xestro page, with the New Patient, Start, Generate, Insert Outputs and Sync i-consult buttons labelled."
```

## The toolbar at a glance

The Akuru top bar sits across the top of your Xestro page and recolours to tell you what state you're in:

- **Green:** connected and idle, ready to go.
- **Red:** transcribing; the **Start** button reads **Pause** and a live timer is shown.
- **Amber:** a patient-name mismatch; the name shows a warning icon (see patient safety below).
- **Dark navy:** disconnected. If i-scribe's state is stale, the bar shows "Reconnecting…" and disables the action buttons until it recovers.

```callout kind="info"
**The bar can sit over Xestro's own buttons** (for example a save or cancel button) near the top of the screen. The floating window is draggable, so grab it and move it down or out of the way if it's covering something you need.
```

## Find the right guide

```callout kind="info"
**Start a consult and pre-fill the patient** → see [Start a consult in i-scribe straight from your EMR](/browser-extension/start-consult-from-emr). Load the patient in Xestro, click **New Patient**, and their details and clinical background flow into i-scribe automatically.
```

```callout kind="info"
**Get a letter into Xestro** → see [Insert a letter into the Xestro letter editor](/browser-extension/insert-a-letter-into-the-xestro-letter-editor). The reliable path is **Create New Letter → click inside the blank letter → Insert Outputs → pick the letter**.
```

```callout kind="info"
**Sync your appointments to i-consult** → see [Sync your appointments to i-consult](/browser-extension/sync-appointments-to-i-consult). Set how many days ahead (1–14) and send them across in one click.
```

## How outputs get back into Xestro

There are two ways to move a generated output into Xestro, and the difference matters:

- **Insert Outputs** (the dropdown on the Akuru top bar). You click the destination field first, then open the dropdown and pick the output. The extension drops it wherever you last clicked. This is the reliable, repeatable path, and it works for every output type.
- **Send to EMR** (a button on each output card inside i-scribe). This smart-routes by type: a medical note goes to Xestro's clinical notes; a letter opens Xestro's letter editor and drops the body in.

```callout kind="warning"
**For letters, prefer Insert Outputs.** Sending a letter via the "Send to EMR" button into Xestro's letter editor can fail, and is the cause of the most common complaint: "I can only get one letter across." The dependable path is to create the letter, click inside it, then use Insert Outputs. See [Insert a letter into the Xestro letter editor](/browser-extension/insert-a-letter-into-the-xestro-letter-editor) for the exact steps, and [I can only export one letter after the first couple of patients](/browser-extension/can-only-insert-one-letter) for the fix to that specific problem.
```

## Patient safety

```callout kind="care"
Before the extension transfers anything (pre-fill, transcription, generate, or insert) it checks that the patient open in Xestro matches the patient in i-scribe. Names are normalised (titles and extra spaces are ignored) so small differences don't trip it up. If they genuinely don't match, the bar turns amber and a warning appears with **Cancel** or **Proceed Anyway**, so a consult can't be silently filed against the wrong record. The match is a safeguard, not a guarantee, so **you remain responsible for confirming the patient is correct.**
```

```faq
### Does the extension work with EMRs other than Xestro?
Right now the extension works with **Xestro**, with the full feature set described here. Support for more web-based EMRs is **coming soon**.

### Can I use Edge? Some of our team prefer it for Xestro.
No. The extension is for **Chrome and Chromium-based browsers** on desktop. Edge isn't supported and isn't on the near-term roadmap. Even if you prefer Edge elsewhere, use Chrome for the extension.

### Do Xestro and i-scribe have to be in the same window?
Yes. They must be side by side **in the same browser window**, not separate windows. Across separate windows, inserting an output can silently do nothing. Keep Xestro in a single active tab as well.

### Where does my data go?
The extension moves data **directly between your Xestro tab and your i-scribe tab** in the browser. It does not send patient data to Akuru servers. See [Is my patient data safe? (security & privacy)](/browser-extension/extension-is-my-patient-data-safe) for the detail.
```