Concepts/Notes

Definition

Clinical Notes is the space where staff record and exchange written notes about a patient. Care groups the messages into titled discussions, so different topics stay separate. You find Clinical Notes in the Notes tab, which shows a panel called Discussions.

Clinical Notes is a Care feature for staff collaboration. Care does not map Clinical Notes to an FHIR R5 resource.

Key Attributes

A discussion groups related messages under one title. A message is one entry in a discussion.

Components	What it captures
Title	The subject of the discussion. The title holds up to 255 characters.
Message	The text of one entry in a discussion. The text supports Markdown formatting.
Author	The staff member who wrote the message. Care records this for you.
Time	The date and time of the message. Care records this for you.

A discussion holds a title only. A message holds text only. This module has no status, no category, and no coded value.

Encounter discussions and patient discussions

Care keeps two separate spaces for discussions:

Encounter discussions belong to one encounter. You see them in the Notes tab of that encounter.
Patient discussions belong to the patient. You see them in the Notes tab of the patient profile.

The two lists never overlap. A patient discussion never appears inside an encounter. An encounter discussion never appears on the patient profile.

Order of discussions and messages

Care lists the discussions with the most recent first. Inside a discussion, the newest message appears at the bottom. Care loads older messages 20 at a time as you scroll up.

Permanence

Care shows no way to delete a discussion. Care shows no way to delete a message. After you send a message, the message stays in the discussion.

Attachments and mentions

Care does not support file attachments in messages. Care does not support user mentions in messages.

Who can see and write

Action	Permission	Roles
See encounter discussions and messages	Can Read encounter related clinical data	Doctor, Nurse, Admin, Facility Admin
Start an encounter discussion, or post a message in one	Update Encounter related clinical data	Doctor, Nurse, Admin, Facility Admin
See patient discussions and messages	Can view clinical data about patients	Staff, Doctor, Nurse, Admin, Facility Admin
Start a patient discussion, or post a message in one	Can Update a Patient's data	Staff, Doctor, Nurse, Administrator, Admin, Facility Admin

If the encounter is closed, you cannot start a discussion in it. You also cannot post a message in it. Care treats an encounter as closed when its status is Completed, Cancelled, Discontinued, or Entered in error.

📝 Note

No deployment setting changes how Clinical Notes behaves.

Pages that link here:

Concept: Concepts/Encounter