OK, I think I can simplify that. Made it pretty confusing. Again, this will be helpful only if I am interpreting your question correctly.

Just start going through your inbox. Take the bottom chart. If it is a message, highlight it and decide to either save it or reply. Either way, it will be out of your inbox. Don't choose no after replying. There may be a few times you want to do that, but most of the time you won't. I tend to want my staff to send it back to me until I sign it off so I can show I was the last one to read it and decide it is done.

I can't comment to much on labs and things that come directly into your inbox. Maybe someone else can.

Charts: Again, open these and decide if it still needs to be processed (a chart that was never charted on) or if it the one you left behind because you said no and then signed off the other chart. Most of the time just compare with the chart you pull from your Patient List.

Worst case scenario, you pull it and save it. So you have two charts of the same encounter. My database has charts in it like that.

Soon enough you will be through your inbox.

Bert
Pediatrics
Brewer, Maine