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Reports and Worklist Issues

Problems signing reports in the Document Viewer, unexpected study statuses, and Worklist behavior. These entries reflect the most common causes RamSoft Support sees, in order of likelihood.

I can't sign a report (nothing happens, or it stays "Initializing...")​

Symptoms

  • Clicking Done/Sign does nothing, or shows "Action completed successfully" while the report stays unsigned
  • An error toast reads "Sorry, error while signing the report, please try again"
  • The report opens as read-only and shows "Initializing..." indefinitely
  • An error mentioning the Report Editing feature appears

Where to look: in the Document Viewer, when you click Done/Sign, or immediately on opening the report (the read-only/"Initializing..." state). The study stays in its pre-signed status on the Worklist.

Likely causes

  1. The study is already SIGNED, which makes the report read-only by design. This is the first thing to check, since it isn't a fault at all: to change a signed report, use Amend to create an addendum, or ask an administrator whether your role should have the permission to modify a locked study
  2. Your role's User Type field is blank - a role like "Reading Physician" with no User Type set silently disables signing
  3. The report is locked by a session on another tab, device, or workstation
  4. A long-lived browser session holding expired tokens
  5. Your organization has Sign Delay enabled - seeing a Pending Signatures dialog after signing is expected behavior in that case, not a bug. Where available, the on/off toggle appears on the organization's General page (the delay itself is a fixed 2 minutes and isn't adjustable); the setting is rolled out per organization, so it's normal for it not to appear at all. Don't confuse it with the Distribute Report delay in Workflow Automation, which is configurable and delays report delivery after sign-off, not the signature itself

What to try

  1. Check the study's status on the Worklist first. If it's already SIGNED, the read-only state is expected, use Amend rather than troubleshooting further.
  2. Ask your administrator to check your role in Users & Roles: the User Type must be set (for example, Reading Physician), not blank. This one setting resolves a surprising share of signing problems.
  3. Close all other tabs/devices, then wait, clearing a session that didn't close cleanly can take some time (up to 15 minutes by default; RamSoft can adjust this for your organization, it isn't a setting your administrator will find).
  4. Perform a hard refresh (Ctrl+Shift+R, or Cmd+Shift+R on a Mac), or sign out and back in, then retry.
  5. If one specific report stays stuck, create a new report on the same study and sign that one; report the stuck one to support.
Checklist: if you need to contact support, send this
  • The accession number and the exact time you tried to sign (with time zone)
  • The exact wording of any message shown when you clicked Done/Sign
  • Whether the report opened read-only / "Initializing...", and whether the study was open anywhere else at the time
  • Whether it happens on every report or only this one, and whether creating a new report on the study let you sign

A report created through a dictation/reporting integration won't save​

Symptoms

  • A report dictated through a third-party voice/reporting integration (Nuance Dragon Medical, M*Modal, or Augnito) fails to save with a generic error

What to try

Change the study status to a state that allows modification before saving the report.

Warning: check your workflow rules first

Status changes can trigger Workflow Automation. If your organization has an auto-send or auto-distribute rule that fires on the status you pick (VERIFIED is a common trigger), moving the study there can send an unfinished report to an external PACS or EMR. Confirm with your administrator which statuses trigger sends before using this as a workaround, and prefer a status that has no rules attached to it.

A clearer in-app error for this case is being addressed separately - report the accession number and the exact error so it can be tracked.

A signed report is missing its header, or shows blank content​

Symptoms

  • A signed report shows a blank body or missing patient header

What to try (amend and re-sign is the supported procedure)

  1. Search for the study by accession number and open the report in the Document Viewer.
  2. Click Amend - the study moves to TO BE AMENDED status.
  3. Add the amendment signature bookmark.
  4. Click Done to re-sign. The header regenerates on signing.
  5. If the header does not appear on screen before signing, return to the Worklist and reopen the report first. The signed PDF displays the header either way.

Note: RamSoft cannot sign or amend reports on a user's behalf - this recovery must be done by a clinician with signing rights.

The report or viewer shows the wrong patient's information​

Symptoms

  • The patient banner, accession number, or images shown don't match the study you meant to open, most often noticed after switching between studies quickly
Patient safety: stop, do not sign

If you ever see mismatched patient information, stop and do not sign. Verify the patient banner against the order before continuing, and report the occurrence to your administrator and RamSoft Support immediately - even if a refresh appears to fix it.

What to try

  1. Close the viewer, perform a hard refresh, and reopen the study directly from the Worklist.
  2. Compare the patient banner, accession number, and images before resuming work.
  3. Report the exact sequence of studies you had open - it helps reproduce the cause.

A study's status changed on its own (for example, to PRIOR after an upload)​

Symptoms

  • A study flips to COMPLETED or PRIOR unexpectedly, often right after importing a document or images
  • A status change you didn't make appears on a study

Likely causes

  1. Late-arriving images re-stamped the status. This is the most common cause by a wide margin. When further objects arrive for a study, the receiving station's "Receive Study Status as" setting is applied again, so a study you had moved forward can be pulled back to the arrival status
  2. A colleague changed it - check before assuming a system error
  3. Your organization's Workflow Automation rules (configured by an admin) changed it - for example, an auto-assign or auto-status-change trigger
  4. An HL7 message from an upstream system recalculated the status
  5. The Auto-Prior rule: a study imported a set number of days after its study date (30 by default, configurable per organization, up to 365), with no status chosen during import, is automatically set to PRIOR

What to try

  1. Check the study's audit log first - it shows exactly what event changed the status, when, and by whom. Most "the system changed my study" reports turn out to be visible there.
  2. When importing into older studies, select a status during import to bypass the Auto-Prior rule.
  3. If a transition you need is blocked from the Worklist right-click menu, open the order and change the status from inside the order details instead - some transitions are only permitted there.
  4. If studies arriving from a modality never advance to Completed on their own, check the DICOM station configuration. When "Receive Study Status as" is left blank, OmegaAI takes the status from the incoming DICOM data rather than applying one of its own, so if the modality doesn't supply a usable status, nothing changes and the study sits where it was (typically SCHEDULED) looking stuck. Set it explicitly to COMPLETED, or whatever status your workflow expects, to fix future arrivals. This is separate from the on-screen status-not-refreshing issue below.

Still stuck? Provide the accession number and the audit log timestamps. RamSoft can bulk-correct statuses on request, and can adjust your organization's Auto-Prior workflow step if it doesn't fit your operation.

The Worklist shows the wrong rows, or filters don't stick​

Symptoms

  • Rows appear that your filter should exclude, or sort order changes on its own
  • A status you just set reverts on screen, or the list doesn't refresh until you re-sort
Note: clearing the browser cache does not fix this

This is a known behavior of the real-time Worklist sync engine updating rows against your applied filter and sort, not a browser cache problem. Support has confirmed cache clearing does not help.

What to try

  1. Re-apply the filter or change the sort to force a clean refresh.
  2. Note the Worklist's filter defaults. Columns like Accession Number and Patient ID open a pick-from-list filter: type to narrow the list, then tick the exact values you want, no operator involved. On plain text columns, typing and pressing Enter without choosing an operator applies Contains, which matches a fragment anywhere in the value, so pick the operator explicitly if you need an exact match. The status dropdown only lists statuses actually present in the current results.
  3. If a filter's operator (Contains, Equals, Starts With) reverts after you save the worklist, that's a known defect RamSoft has reproduced, not something you're doing wrong. Re-apply the operator after loading, and report it so it can be tracked against the existing fix.
  4. Report persistent cases with a screenshot and the exact filter/sort in use - the underlying real-time sync improvements are tracked by RamSoft.

Still stuck? Describe the filter and sort applied and which rows appeared or disappeared incorrectly.

I can't find where to customize Worklist columns​

Symptoms

  • The option to add/remove or reorder columns seems to have disappeared

Why: the current Worklist moved where you edit a Worklist. If you remember a column-customization control sitting directly on the older worklist view (retired at the cutover to the current Worklist), it isn't in the same place now.

What to try

  1. Hover over the Worklist name in the top-left (or open the dropdown next to it to see all your worklists).
  2. Click the pencil / edit icon that appears - this opens the Worklist editor panel, where columns are added, removed, and reordered.

This applies to all of your worklists, not just the default. For the full walkthrough of worklist editing, see the New Worklist guide.

If the worklist is shared (a role worklist rather than your personal one), column changes affect everyone using it, so check which kind you're editing before saving.

Worklist actions are missing (Merge option gone, menu cut off)​

Symptoms

  • The right-click menu shows only a few actions; Merge Study / Link & Merge Patient is missing, even for admins
  • Menu items appear cut off on certain rows

Likely causes

  1. The user's User Type field is blank (again - this setting gates several actions)
  2. The role lacks the specific permissions (Image Viewer > QC Module > Merge/Unmerge Studies; Patient > Link & Merge Patient)
  3. Multiple studies from different organizations are selected - multi-org selections intentionally limit available actions
  4. Browser zoom or display scaling clipping the menu

What to try

  1. Set the User Type on the role (for example, Performing Technologist) - the options return immediately.

  2. Verify the role's merge permissions with your administrator.

    Patient safety: verify before you merge

    Verify patient/study identifiers carefully before merging, there is no self-service undo for a wrong merge.

  3. Select studies from a single organization and retry.

  4. Reset browser zoom to 100% (Ctrl+0, or Cmd+0 on a Mac) and check your operating system's display scaling.

A study I expect is missing from my Worklist​

Symptoms

  • A study exists (patients or colleagues confirm it) but your Worklist doesn't show it

Likely causes

  1. Active Worklist filters or a saved view excluding the study
  2. Your user isn't assigned to the study's organization - missing child-organization assignment is the most frequent cause
  3. The study is under a duplicate patient record

What to try

  1. Clear all filters and search again, or use Global Search.
  2. If the name search doesn't find it, search by accession number - it's more reliable than name matching.
  3. Ask your administrator to confirm your user is assigned to the correct organization including child organizations.

Still stuck? Provide the accession number and which Worklist view/filters you were using.

Who can see which studies (too many, or too few)​

This is a role/permissions setting, not a Worklist bug. See Who can see which studies (too many, or too few) in Permissions, Roles and Organizations for the full explanation and fixes.