Visit Notes

A visit note is Elation’s record of a clinical encounter. In the hosted database each note is modeled as two tables: a record for the note itself and a set of rows for its content.

visit_note: one row per visit note, holding the note’s metadata (patient, practice, author, sign-off, and timing).
visit_note_bullet: one row per line of content within a note, joined to its note by visit_note_bullet.visit_note_id = visit_note.id.

For the full column list of every table mentioned here, see the hosted database schema reference.

Note content

A note’s content is stored as bullets in visit_note_bullet. Each bullet has:

a category naming the section it belongs to (Reason, HPI, Assessment, Plan, Orders, and so on),
a sequence giving its order within that section, and
an optional parent_bullet_id, since bullets can be nested under a parent.

A bullet carries its content in one of two ways. Most bullets hold typed prose directly in text: the narrative a clinician writes in sections like Reason, HPI, Assessment, and Plan. Other bullets instead reference a separate record (a placed order, an attached or referenced document, or a problem-list item); their text is empty because the content lives in that linked record rather than on the bullet.

How visit notes relate to other data

Visit notes connect to the wider data model through these relationships:

Related data	Relationship
Patient	`visit_note.patient_id` → `patient.id`
Authoring / signing user	`visit_note.physician_user_id`, `signed_by_user_id`, `created_by_user_id` → `user.id`
Bills	`bill.visit_note_id` → `visit_note.id`. The billing-section provider roles live on `bill` itself (`rendering_provider_id`, `supervising_provider_id`, `billing_provider_id`, `referring_provider_id`) — `visit_note.physician_user_id` is the note’s author and is not necessarily the rendering provider on the bill. See Visit Notes and Bills.
Document tags	`visit_note_document_tag.visit_note_id` → `visit_note.id`
Orders (medication, lab, referral, and other placed orders)	Orders are their own documents, linked to the patient rather than joined to the note. Query them by patient in Medication Orders, Lab Orders, and Referrals.
Other referenced documents (lab reports, attachments)	The link between a bullet and the document it references is not exposed in the hosted database. Where the content has its own patient-level table (such as `lab_result`), query it by patient; otherwise it is not available through the note.

Reading a note’s content

This returns every content line for a single note, in display order:

select
    b.visit_note_id
  , b.category
  , b.sequence
  , b.text
from visit_note_bullet b
where b.visit_note_id = <visit_note_id>
  and b.is_deleted = false
order by b.category, b.sequence;

Bullets that reference a separate record (such as placed orders) return empty text; retrieve that content from the related tables described in How visit notes relate to other data. If you have any questions about this topic please reach out to Elation Support Portal with the subject line HDB - <your_question>

Hosted Database

Overview

How Tos

Common Queries

Elation Billing

Frequently Asked Questions

Changelog

Note content

How visit notes relate to other data

Reading a note’s content

​Note content

​How visit notes relate to other data

​Reading a note’s content

Note content

How visit notes relate to other data

Reading a note’s content