Two independent boundaries close a clinical entry. The first is the edit window β 48 hours, after which the content becomes read-only. The second is the signature, which closes the entry immediately and has nothing to do with those 48 hours.
The order has a practical consequence: Heltio checks the signature before the time window. That way, for a signed entry from a week ago you get an answer you can do something about β "use an amendment" β instead of being told the time has run out and there is no way through.
How long the edit window lasts
The 48-hour clock starts when the visit ends, not when the note is written. As long as the visit is in progress, no limit applies β document as much as you need. A note with no linked visit counts its 48 hours from creation.
After that, the editor shows The 48-hour edit window has closed. This note is now read-only. An unsigned entry past a closed window can no longer be corrected or signed β you add a new note to the same visit.
How to do it
Sign the entry
At the bottom of the card stands Save and sign the visit, and below the button the sentence After signing, the entry becomes unchangeable. Later changes are possible only as an amendment.
Clicking it opens Sign and lock this entry? with the text: "The signature attests the content of the medical record. A signed entry cannot be edited β any change becomes a separate, linked amendment with a stated reason." You confirm with the Sign entry button; Heltio acknowledges with The entry has been signed and locked.
The format selector bar is then replaced by a closure bar: a padlock, Signed, Signed together with the practitioner's name and the date, and for corrections also Version 2 and Amendment.
Check the state when closing the visit
The summary that ends the visit shows Visit card: signed or Visit card: not signed. In the second case the Go to signing button scrolls the screen straight to the signing button. Completing the visit and signing the entry are two separate acts β you can close the visit without a signature too.
Correct a signed entry with an amendment
On the closure bar stands Add amendment. It opens the Amend a signed entry dialog: "A new revision pre-filled with the original content will be created. The signed original remains unchanged in the record."
You fill in the Reason for amendment β a minimum of 10 characters, because the reason is part of the medical record. The field's hint reads "E.g. an incorrectly entered examination resultβ¦". You confirm with Create amendment; Heltio acknowledges with Amendment created β you are editing the new revision.
The author of the amendment is the person who made it, not the author of the original. At hospital sites an amendment written by a Trainee goes into the countersign queue exactly like the original entry.
Read the chain of revisions
Every amendment gets the next number: Version 2, Version 3. An older revision, when opened, shows This entry has been amended β a newer revision applies. and a Go to the current revision button. In the note view on the patient record you will see Signed {date}, Version {number}, Amendment reason: {reason} and Previous versions ({count}).
Only the newest revision can be corrected. The original does not receive a single write β that is what an amendment is for.
When something goes wrong
NOTE_SIGNED_LOCKEDThis entry is already signed.
What this means: A signed entry is closed to any change of content β including marks on the body chart and an edit sent from the mobile app once the connection returns.
EDIT_WINDOW_CLOSEDThe 48-hour edit window has closed. This note is now read-only.
What this means: More than 48 hours have passed since the visit ended, and the entry was not signed.
The entry changed since it was last loaded β review the content and sign again.
What this means: Between loading the entry and clicking sign, the content changed elsewhere β usually the same visit was open on a second device.
Only the author can sign this entry.
What this means: An attempt to sign a note written by somebody else.
An empty entry cannot be signed β fill in the visit card.
What this means: Every field of the note is empty.
This entry already has a newer amendment β open the current revision.
What this means: You are correcting a revision that has been amended in the meantime β by a second person, for example.
An amendment can only be added to a signed entry.
What this means: The entry is not signed, so an amendment is unnecessary.
This note was changed on the server. Your offline edit wasn't applied.
What this means: A card worked on with no signal came back to an entry that somebody had signed or countersigned in the meantime.
Who has access
Practitioner Clinic AdminSigning and amending are open to the roles that keep documentation: Practitioner, Coordinator, Senior Physiotherapist, Trainee, Occupational Therapist, Speech and Language Therapist, Psychologist, plus the Owner and the Administrator. Assistant / Reception, Technician / Massage Therapist and read-only clinical access sign nothing.
Signing and countersigning are two independent things with opposite rules: a signature is given only by the author, a countersignature only by somebody else. An entry can carry both markers at once β Signed and Pending countersign.
The lock works inside Heltio itself: no path in the application will change the content of a signed entry, and a hash of the content is stored at signing time, so later interference from outside the application is detectable. The signature, the amendment and the countersignature all go into the audit log together with the reason for the amendment.
Related
- Clinical notes β the four note formats and the practice templates.
- Visit card β the format you sign most often.
- Active session β the screen where the signing button sits.
- Roles and permissions β who signs and who countersigns.
Related features
Clinical notes, signing and amendments
Four note formats, practice templates, the 48-hour edit window, and the signature that closes an entry for good β with the amendment as the only route to changing it.
Visit card
A structured record of the examination β interview, physical examination, functional tests, hypothesis, therapy plan and coding, filled in during the visit and closed with a signature.
Active session β working during a visit
The screen you work on from the moment the patient walks in until they leave: the clinical note, range-of-motion measurements, the treatment plan, attachments and the summary that closes the visit.
Audit log
A record of who reached for patient data and when, and who changed it. Filters, export to CSV or JSON, the starting point for a GDPR inspection and for internal explanations.
Roles and permissions
Thirteen roles: four in an ordinary clinic, eight more in a hospital facility and one on the patient side. What each one sees, what it can change, and why a role cannot be overridden with a single permission.