Leslie,
Thanks for clarifying. I, too, via a really cool intraoffice email system, really like it if the referral to a specialist or a procedure is documented before the patient makes it to the front desk. How cool is it when they get there and find out that they have an appointment made for both.
I guess I would offer the following. Now, if the chart is going to multiple places, then having a save but not sign feature would be helpful. I would argue that this would leave multiple chances for screw ups as well. I think if I attached a Word document (which of course you can't do) and each opened it and then saved it before passing it along, this would give multiple chances for problems.
I guess even sending it your inbox doesn't change the fact that they still can't save it along the path they are sending it. I would say though as far as risk/benefit goes the three seconds it takes to send it to your inbox would be worth the risk of losing the note altogether. If prior to Brian's discovery of the shortcut key one had to use the button at the bottom right and put their name in the dropdown window, it would be a hassle. But, CTRL - S and then clicking on the note before sending it seems like a small tradeoff.
Even Microsoft Word has a rather complicated system of saving a note. You can actually save the note in which you can NEVER go back to a certain point in a document or it has the autosave fetaure which saves it but also allows you to go back to multiple points in the document. It would probably be hard to save the note along the way as far as code goes.
But, having said all this, I will now gracefully stop giving my opinion as it sounds like you have a very good system in place. Good luck. I do see your point.