Attachments/Images Ability Overview

The Attachments and Images Abilities attach nonproprietary files such as .gif, .tiff, .bmp, .jpg, .png, and .pdf files to patient accounts. Attachments and Images are almost identical Abilities with some differences.

Images is a free standard MacPractice ability used to attach files to patient accounts.

Attachments is a purchased MacPractice ability that works similarly to Images, but also allows files to be imported automatically. The Attachments Ability is also able to attach proprietary file formats for easy storage and retrieval. MacPractice may not be able to display the information in these other formats from directly within MacPractice, however this feature will allow you to be able to store Attachments and link them to patient records.

With Attachments, you are also able to upload .mov and .mp4 files.

This article provides an overview of how to navigate the Attachments Ability, how to import attachments and categorize them to easily sort them later, and how to set up an Import folder that can automatically import attachments placed in a particular folder.

Attachments are added to a separate attachments database which can be backed up separately. However, attaching files does increase the size of the database and the size of media and time required to create database backups. Please see the Backup documentation for more information on developing an appropriate backup scheme.
Navigating in the Attachments Ability
The Attachments Ability is divided into several nodes that change behavior depending on whether you have a patient selected or not.
With no Patient selected, you are able to access all attachments tied to patients by navigating to Thumbnails or Patient Attachments in the Sidebar. If you have a patient selected, the results will hone down to Attachments assigned to that specific patient. 
If you have a specific attachment you are looking for, you can search for it by using the Search Bar right above the Attachments sidebar.
Let's review what each node contains in the sidebar.


Thumbnails Node
This node, when expanded, will display a preview of all patients with Attachments/Images associated with them if no patient is selected. With a patient selected, thumbnails will appear in the window of all of their attachments. You can click once to select a thumbnail, or double click it to open the Attachment in Preview. A .mov file might be viewed in Quicktime, while a .pdf or .jpg file might be viewed in Preview, and so on.
This view is most useful when a patient has several attachments added to their account and you're looking for a particular one.
At the top of the Thumbnails Node, you'll note there is a slider to control the size of the Thumbnails that you can adjust to your preference.


Patient Attachments Node
When expanded, this node will list all attachments associated to the selected Patient, or display all attachments if no patient is selected.
In Preferences > Attachments, you can adjust how many attachments will display with no patient selected, using the "Display Attachments Newer Than (x) days old when on Many" preference.
When you select a name, an image of the attachment will appear, along with all other information, including file name, Incident (if the attachment is linked to an Incident), Attachment Type, Description, Procedure Date and Attachment Status. There is also a button present that will allow you to associate the selected attachment to another patient. 
Locked Patient Attachments Node
Any attachment can be dragged to this node, which will lock down the Attachment so no changes can be made to any of the associated fields. Before locking an Attachment, make sure that all fields are filled out so you won't need to unlock it later.


Attachments Node
The Attachments node contains Attachments that have NOT been associated to a particular Patient. Once associated, the Attachment will be visible in the Patient Attachments or Thumbnails node. You can associate an Attachment to a Patient by using the "Associate to Patient" button. This will open up the Patient Selection window where you can select the appropriate Patient.


Patient Photos Node
This node contain photos associated with a patient's record that can be seen in the Patient Selector. This photo can be configured to appear in the Schedule blocks associated to this Patient by adjusting Appointment Display settings appropriately.
The photo will also appear on the Patient Photo for the patient.
If no patient is selected, the Patient Photos node will display all patients that have a Patient Photo associated with them. If a patient is selected, this node will only display any photos associated with the patient that have been added to this node.
You can use the Camera Button to take pictures for this purpose. More on the Camera Button can be found here.

Attachment Type Node
This node allows you to create, delete, and organize different Attachment Types you can set for your Attachments. You can create and remove Types by using the Plus and Minus icons in the sidebar.
The "Show this type as a node" checkbox can be used to add a new category node in the sidebar so you can quickly access a particular type of Attachment. For example, in the below screenshot you will see an Insurance Card node, which is an Attachment Type set to display in the sidebar. 
Important: When adding a new Attachment Type, they'll be added to the bottom of the sidebar. In order for the Attachment Type to appear in the expected order, you will want to log out and back into MacPractice.
All Attachments with this Type will be listed in this category node. 


Attachment Status Node
 This node allows you to create, delete, and organize Attachment Statuses that you can set for your individual Attachments. This behaves similarly to the Attachment Type node.
You an also add a particular Status as a Node to the sidebar by using the "Show this status as a node" checkbox. This is useful if you need to refer to a particular set of Attachments with a specific Status set.
Important: When adding a new Attachment Status, they'll be added to the bottom of the sidebar. In order for the Attachment Status to appear in the expected order, you will want to log out and back into MacPractice.
Importing Attachments 
There are several methods that can be used to import Attachments into MacPractice. Let's review each of these in turn:
Drag and Drop
The easiest method to import Attachments is the Drag and Drop method. Simply drag and drop the Attachment you wish to import into the Attachments window.
If you have a Patient selected, the attachment will associate immediately with that Patient.
If there is no Patient selected, the Attachment will be placed in the Attachments node and you can later associate it with a Patient using the Associate to Patient" button.
An alternative method is to use the Browse button present in the Attachment view (between File and Incident) to select a file that you wish to upload as an Attachment.

It is important to note that if you use either the Drag and Drop method or the Browse method with an Attachment already selected, you will be prompted whether you want to replace the existing record or not. You can choose to cancel, replace the existing record, or create a new record.

Import Folder
For many offices, they will have a workflow of scanning in images via a scanner of some kind, and will need to immediately import attachments into MacPractice. To streamline this process, we have the option of setting up an Import Folder, which will automatically upload any attachments placed in the folder directly into MacPractice.
To set up an Import folder, first navigate to the MacPractice Menu > Preferences > Attachments.
From here, you will first need to set an Import Path. This is the location where MacPractice will pull files from to import them as Attachments. It's important that this path be one that is exclusively used just for this purpose. It's also a good idea to set this path that your scanner is pointed at to save scanned images.
Once an Import Path is set, you can then check the 'Enable Import Folder' checkbox. Once this is enabled, all images that enter this folder are imported into MacPractice and then removed from the Import Folder.
There is an option at the bottom of Preferences > Attachments "Do Not Automatically Associate Imported Files to Patients". This option, if disabled, will associate any attachment imported to the currently selected patient. For some offices, this is perfect, as they are always scanning attachments for the immediate patient they have selected right now. Other offices may want to enable this option if they aren't always scanning in items for the immediate patient, or if they simply want a bit more manual control over how they handle their attachments. 
Anatomage Files
In Build 10, we've added the ability to upload Anatomage files to the Attachments ability to store them within your database. Specifically, you can now upload files with the extensions .amg, .api, and .inv. This is a purchased option within MacPractice.
Without the purchased option, you will not be able to utilize an auto-import folder to automatically pull these files into MacPractice and will have to rely on manually uploading these files into MacPractice.


Archiving, Deleting, and Unarchiving Attachments

To archive an image, select the Attachment and click the minus button in the sidebar. Confirm the archive by clicking the Archive button on the resulting window. You can also select the Attachment and navigate to the Edit Menu and select "Delete Record".

You'll see a prompt asking if you'd like to archive the attachment, or delete the attachment.


If you need to unarchive an attachment, you can use the File Menu and select > Retrieve Archived > Attachment. This will open up a window where you can select which attachments to unarchive.

Attachment Attributes

Attachment Attributes are fields that allow you to organize and define attachments based on their Status, Type, Associated Patient, Description, Procedure Date, and Incident.
Associate to Order 
This button will be present if the attachment is already associated with a patient. It allows you to associate an attachment to a new order or an existing order. Click the button and it will bring up a list of open orders. From this window, you can also use the Green Plus in the upper right hand corner to create a new Order. 
From there you can add a new order or select an existing one.


Patient/Associate to Patient Button
This area indicates which patient the attachment is associated with. If the attachment is not associated with a patient, an "Associate to Patient" button will be present. Associating an attachment will move the Attachment from the Attachments node to the Patient Attachments node.
If the attachment is associated with a patient, the patient's name and account number will be listed in this space. If the patient chosen is the incorrect one, you can re-select the patient by clicking the drop-down triangle icon to the left of the Patient field. 



File name
The full file name of the file that was imported. This field cannot be changed and is purely used for reference.


This drop down menu allows you to associate an attachment to a specific Incident. This will cause the attachment to show up in the Clinical Tab or Clinical Ability with the Incident selected.

Attachment Type

This drop down allows you to select an Attachment Type to tie to this attachment.

If the Attachment Type is set to display as a node in the sidebar (see Attachment Types)


This field is used to add a description of an attachment. This field is searchable, so if you type in the sidebar search for a term that a description uses, that attachment will appear in the search results.

The description is also visible in the sidebar when scrolling through attachments.


Procedure Date

This field allows you to set a Procedure Date for a particular attachment. The Procedure date will default to the date this Attachment was added, but can be altered to suit your needs.


Attachment Status 
This drop down allows you to select an Attachment Status to tie to this attachment. If the Attachment Status is set to display as a node in the sidebar (see Attachment Statuses) this will cause this attachment to be included in that node.

Setting Up Scanners

Any Mac compatible scanner can work with MacPractice. To import files from the scanner to MacPractice, an import folder is created. Next, both the scanner and MacPractice need to have the path of this folder set within their settings. This will allow the Import Folder to work as a bridge, connecting the output of the scanner to the input in the Attachments ability.

The following specific device guides are available:



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