Medical Records

A complete guide to the Medical Records module — vitals, clinical notes, diagnoses, attachments, and the visit timeline.

Written By Dev010

Last updated 19 days ago

The Medical Records module provides a structured way to document everything that happens during a patient visit — vital signs, clinical notes, diagnoses, and file attachments. Records are organized per patient and can be linked to a specific appointment.

Clinic type note: The Medical Records module appears in the sidebar for general and ophthalmology clinic types. Dental clinics use the Odontograms module instead.

Accessing the Module

Sidebar → Medical Records

Direct URL:

https://yourdomain.com/dashboard/medical-records

Who can access:

Action	Admin	Doctor	Receptionist	Nurse
View records	✅	✅	❌	✅
Create records	✅	✅	❌	✅
Edit records	✅	✅	❌	❌
Delete records	✅	❌	❌	❌

Module Structure

Medical Records is divided into five sub-sections, each accessible from the sidebar under Medical Records:

Section	Purpose
Vitals	Blood pressure, heart rate, temperature, weight, height, BMI
Clinical Notes	Free-text notes written by doctors or nurses
Diagnoses	Formal diagnoses with ICD codes and status
Attachments	Uploaded files — PDFs, images, documents
Visit Timeline	Chronological view of all records per patient

Vitals

Accessing Vitals

Sidebar → Medical Records → Vitals

https://yourdomain.com/dashboard/medical-records/vitals

What Vitals Records

Each vitals entry captures a snapshot of a patient's physical measurements at a point in time:

Field	Description
Patient	Linked patient
Appointment	Optional — link to a specific visit
Recorded By	Staff member who recorded the vitals
Recorded At	Date and time of measurement
Blood Pressure Systolic	mmHg
Blood Pressure Diastolic	mmHg
Heart Rate	Beats per minute
Temperature	°C or °F
Weight	kg
Height	cm
BMI	Calculated automatically from weight and height

Adding Vitals

Click Add Vitals on the vitals page.

Select the patient, optionally link to an appointment, fill in the measurements, and save. Not all fields are required — record only the measurements taken during the visit.

BMI is calculated server-side from weight (kg) and height (cm) when both are provided. You do not need to calculate it manually.

Vitals Table

The vitals list shows all recorded vitals across all patients with the most recent entries first. Each row shows:

Patient name
Blood pressure (systolic/diastolic)
Heart rate
Temperature
Weight and height
BMI
Recorded by and recorded at

Clinical Notes

Accessing Clinical Notes

Sidebar → Medical Records → Clinical Notes

https://yourdomain.com/dashboard/medical-records/clinical-notes

What Clinical Notes Record

Clinical notes are free-text entries written by doctors or nurses during or after a patient visit:

Field	Description
Patient	Linked patient
Author	Staff member writing the note
Appointment	Optional — link to a specific visit
Content	Free-text clinical note
Created At	Timestamp of note creation

Adding a Clinical Note

Click Add Clinical Note on the clinical notes page.

Select the patient, optionally link to an appointment, write the note content, and save.

Clinical notes are attributed to the logged-in user automatically as the author. The author cannot be changed after creation.

Clinical Notes Table

The notes list shows all notes across all patients with the most recent first. Each row shows patient name, author, note excerpt, linked appointment, and creation date.

Diagnoses

Accessing Diagnoses

Sidebar → Medical Records → Diagnoses

https://yourdomain.com/dashboard/medical-records/diagnoses

What Diagnoses Record

Diagnoses are formal clinical findings associated with a patient:

Field	Description
Patient	Linked patient
Doctor	Diagnosing doctor
Title	Diagnosis name or description
ICD Code	Optional — international classification code
Status	`active` or `resolved`
Diagnosed At	Date of diagnosis

Diagnosis Status

Status	Meaning
`active`	Condition is current and ongoing
`resolved`	Condition has been treated or resolved

Status can be updated at any time — for example changing a diagnosis from active to resolved after successful treatment.

Adding a Diagnosis

Click Add Diagnosis on the diagnoses page.

Select the patient and doctor, enter the diagnosis title and optional ICD code, set the status and date, and save.

Diagnoses Table

The diagnoses list shows all diagnoses across all patients. Each row shows patient name, title, ICD code, status badge, doctor, and diagnosis date.

Attachments

Accessing Attachments

Sidebar → Medical Records → Attachments

https://yourdomain.com/dashboard/medical-records/attachments

What Attachments Store

File uploads linked to a patient — lab results, X-rays, referral letters, scan reports, or any supporting documents:

Field	Description
Patient	Linked patient
Appointment	Optional — link to a specific visit
File Name	Display name of the file
File URL	Storage URL in Supabase
File Type	MIME type of the uploaded file
Created At	Upload timestamp

Supported File Types and Limits

Type	Formats	Max Size
Documents	PDF, DOC, DOCX	10MB
Images	JPEG, PNG, GIF, WebP	10MB

Files are stored in the medical-attachments Supabase storage bucket. Confirm this bucket exists and is set to Public before uploading — see the Supabase Setup guide.

Adding an Attachment

Click Add Attachment on the attachments page.

Select the patient, optionally link to an appointment, choose the file from your device, and save. The file uploads to Supabase Storage and a record is created in the medical_attachments table.

Attachments Table

The attachments list shows all uploaded files across all patients. Each row shows patient name, file name, file type, linked appointment, and upload date. Click the file name to open or download the file.

Visit Timeline

Accessing the Visit Timeline

Sidebar → Medical Records → Visit Timeline

https://yourdomain.com/dashboard/medical-records/visit-timeline

What the Visit Timeline Shows

The visit timeline gives a chronological view of all medical activity for a patient across all record types in a single view.

Two layout options are available:

Card View — Each visit is displayed as a card showing the date, linked appointment, doctor, and all records from that visit — vitals, notes, diagnoses, and attachments grouped together.

Gantt View — A horizontal timeline showing the span of active diagnoses and visits across time. Useful for understanding the duration of ongoing conditions.

Searching the Timeline

Use the search bar on the visit timeline page to filter by patient name. The timeline updates to show only records for the selected patient.

Medical Record Visits

In addition to the individual sub-sections, CareNova also has a top-level medical_records table that represents a visit record — a container that links a patient, doctor, and appointment to a specific date.

Field	Description
Patient	Linked patient
Doctor	Attending doctor
Appointment	Optional linked appointment
Visit Date	Date of the visit
Status	`open` or closed

Vitals, clinical notes, diagnoses, and attachments can all be linked to both a patient and an appointment — they do not strictly require a parent medical record row. The medical_records table provides an optional grouping layer for visit-based workflows.

Database Schema Reference

medical_records

Column	Type	Description
`id`	uuid	Unique record ID
`patient_id`	uuid	FK → patients
`doctor_id`	uuid	FK → users
`appointment_id`	uuid	FK → appointments
`visit_date`	timestamptz	Date of visit
`status`	text	open / closed
`created_at`	timestamptz	Creation timestamp

medical_record_vitals

Column	Type	Description
`patient_id`	uuid	FK → patients
`appointment_id`	uuid	FK → appointments
`recorded_by_id`	uuid	FK → users
`recorded_at`	timestamptz	Measurement time
`blood_pressure_systolic`	integer	mmHg
`blood_pressure_diastolic`	integer	mmHg
`heart_rate`	integer	BPM
`temperature`	numeric	Degrees
`weight`	numeric	kg
`height`	numeric	cm
`bmi`	numeric	Calculated

clinical_notes

Column	Type	Description
`patient_id`	uuid	FK → patients
`author_id`	uuid	FK → users
`appointment_id`	uuid	FK → appointments
`content`	text	Note content
`created_at`	timestamptz	Creation timestamp

diagnoses

Column	Type	Description
`patient_id`	uuid	FK → patients
`doctor_id`	uuid	FK → users
`title`	text	Diagnosis title
`icd_code`	text	ICD classification code
`status`	enum	active / resolved
`diagnosed_at`	timestamptz	Date of diagnosis

medical_attachments

Column	Type	Description
`patient_id`	uuid	FK → patients
`appointment_id`	uuid	FK → appointments
`file_name`	text	Display name
`file_url`	text	Supabase storage URL
`file_type`	text	MIME type
`created_at`	timestamptz	Upload timestamp

Workflow Examples

Recording a complete patient visit:

Nurse records vitals — Medical Records → Vitals → Add Vitals
Doctor writes clinical note — Medical Records → Clinical Notes → Add Clinical Note
Doctor adds diagnosis — Medical Records → Diagnoses → Add Diagnosis
Doctor uploads lab result — Medical Records → Attachments → Add Attachment
Review full visit — Medical Records → Visit Timeline

Updating a resolved diagnosis:

Medical Records → Diagnoses
Find the diagnosis row
Edit → change status from active to resolved → Save

Reviewing a patient's complete medical history:

Sidebar → Patients
Find the patient → View Full Profile
Navigate through tabs — appointments, prescriptions, medical records

Troubleshooting

Medical Records not in sidebar:

Confirm clinic type is general or ophthalmology — dental clinics show Odontograms instead
Confirm your role has medical_records.view permission in Dashboard → Permissions
Receptionist does not have medical records access by default

File upload failing:

Confirm the medical-attachments bucket exists in Supabase Storage and is set to Public
Confirm file is under 10MB
Confirm file type is PDF, DOC, DOCX, JPEG, PNG, GIF, or WebP
Confirm SUPABASE_SERVICE_ROLE_KEY is correctly set in environment variables

Vitals not showing BMI:

BMI is only calculated when both weight (kg) and height (cm) are provided
Confirm both fields were filled in when recording vitals

Visit timeline showing no records:

Confirm the patient has at least one vitals, clinical note, diagnosis, or attachment record
Use the search bar to filter by the specific patient name

Next Step

Continue to the Prescriptions module guide to learn how to create and manage patient prescriptions in CareNova.