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Module: Practice Management (PM)
Feature: PM-01 Patient Registration & Demographics
Version: 1.0
Updated: 2026-02-18

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Overview

This guide covers permission configuration, role assignments, audit considerations, and data management for the Patient Registration feature (PM-01).

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Permission Key Reference

Permission KeyConstantDescription
pm.patients.viewPM_PERMISSIONS.PATIENTS_VIEWView patient list and detail pages
pm.patients.createPM_PERMISSIONS.PATIENTS_CREATERegister new patients (shows Register button)
pm.patients.updatePM_PERMISSIONS.PATIENTS_UPDATEEdit demographics and manage child records
pm.patients.mergePM_PERMISSIONS.PATIENTS_MERGEMerge duplicate patient records (Phase 2 — not yet active)

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Default Role Assignments

These assignments are seeded by the PM-01 database migration (pf_role_permissions):
System RoleViewCreateEditMerge
org_admin✅✅✅✅
site_admin✅✅✅—
staff✅✅——
readonly✅———
Note: The org_admin role automatically receives all active permissions via the platform trigger. Custom roles can be configured in Settings > Permissions.

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Managing PM Permissions

  1. Navigate to Settings > Permissions (requires org_admin role).
  2. Select the Practice Management module from the module list.
  3. Assign or revoke permissions per role using the toggle interface.
  4. Changes take effect immediately for newly issued tokens; existing sessions refresh on next page load.

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MPI Duplicate Override Audit

When a staff member overrides a duplicate warning during patient registration:
  • The override reason is stored in the patient’s custom_fields JSONB column under the key mpi_override_reason.
  • The created_by column records which user performed the registration.
  • The created_at timestamp provides the exact time of registration.
To audit overrides, run the following query in the Supabase SQL editor: 
SELECT 
  id,
  mrn,
  first_name,
  last_name,
  created_by,
  created_at,
  custom_fields->>'mpi_override_reason' AS override_reason
FROM pm_patients
WHERE 
  organization_id = '<your_org_id>'
  AND custom_fields->>'mpi_override_reason' IS NOT NULL
ORDER BY created_at DESC;

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Soft Delete vs. Permanent Delete

Patient records and child records (addresses, contacts, guarantors) use soft deletion — the deleted_at column is set to the current timestamp, and records are hidden from standard views. Soft delete behavior:
  • Records remain in the database for audit and recovery.
  • Application queries filter deleted_at IS NULL.
  • RLS policies enforce this at the database level.
To restore a soft-deleted record (administrators only): 
UPDATE pm_patients
SET deleted_at = NULL, updated_at = NOW()
WHERE id = '<patient_id>'
  AND organization_id = '<your_org_id>';
Permanent deletion is not available through the UI and should only be performed by a database administrator in compliance with your organization’s data retention policy.

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Module Settings

The pm_module_settings table contains organization-specific configuration for the PM module. Currently, the settings UI is not exposed (Phase 3). Direct database edits can be made for:
SettingDefaultDescription
patient_number_prefix'MRN-'Prefix for manually entered MRNs
duplicate_detection_enabledtrueEnable MPI duplicate check on registration
To view current settings: 
SELECT * FROM pm_module_settings WHERE organization_id = '<your_org_id>';

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Database Tables

TableDescription
pm_patientsCore patient demographics (USCDI v3)
pm_patient_addressesPatient address records (soft-delete)
pm_emergency_contactsEmergency contact records (soft-delete)
pm_guarantorsFinancial guarantor records (soft-delete)
pm_module_settingsOrganization-level PM configuration
All tables have RLS enabled with FORCE ROW LEVEL SECURITY. SECURITY DEFINER helpers (pm_has_org_access, pm_can_access_patient, pm_can_modify_patient) prevent RLS recursion.