Note amendments
Append corrections or additional info to a locked clinical note.
Overview
Locked clinical notes can't be edited — that protects against retroactive tampering. But mistakes happen, and patients sometimes provide info after the visit. Amendments are append-only additions that say "on this date, I corrected/added...". Approval by Admin or Owner is required.
Prerequisites
- Clinical role
- A locked clinical note that needs correction
Steps
Open the locked note. Patient profile → Notes → click the note.
Click "Add amendment". A dialog opens.
Type the amendment. Be explicit: "Correction: dose was 500 mg, not 250 mg". Don't rewrite the original — describe the correction.
Specify why. Required reason — patient feedback, additional info from specialist, error caught during review.
Submit for approval. Amendment status PENDING_APPROVAL. The clinical Admin or Owner gets a notification.
Admin/Owner approves. They open the amendment, review, click Approve. Status flips to APPROVED. The amendment is now visible on the note.
View on the locked note. The note now shows the original body plus the appended amendment with timestamp and approver.
Reject the amendment. Reviewer can reject with reason. Returns to author for revision or abandonment.
Expected outcome
- A new Amendment entry exists, linked to the original note
- After approval, the note shows both body and amendment
- Audit log captures author, approver, reason
Troubleshooting
| Symptom | Likely cause | Fix |
|---|---|---|
| Amendment doesn't appear | Pending approval | Owner/Admin must approve first |
| Want to amend an amendment | Cascading amendments OK | Add another amendment to the note (not the prior amendment) |
| Reviewer wants to reject | Click Reject with reason | Author can resubmit |
| Approval bottleneck | Owner away | Designate Admin to approve |
| Patient demands removal of an amendment | Per audit policy, amendments can't be removed | Add a clarifying amendment instead |