Alert Rules

Clinical Alerts are generated based on document-driven activity observed across participating national health information networks. Alert generation depends on enrollment status, successful document retrieval, encounter inference, and evaluation within an active observation window.

Not all network activity results in an alert.

Observation Window

Alert evaluation occurs within a defined observation window:

The window begins when a qualifying network query is detected.
The window remains active for up to 10 days.
Qualifying document retrieval and analysis must complete within this window for an alert to be generated.
If no qualifying documents are retrieved during the observation window, no alert is generated.

Observation windows are evaluated per patient and per qualifying query event. Overlapping windows may occur if multiple qualifying queries are detected for the same patient.

Alert Conditions

An alert is generated only when all of the following conditions are met:

The patient is enrolled when qualifying document retrieval and analysis are processed within an active observation window.
A qualifying network query is detected.
One or more clinical documents are successfully retrieved.
Retrieved documents contain sufficient clinical context to support inference of clinically meaningful activity.
Document analysis completes successfully within the active observation window.

If any of these conditions are not met, no alert is generated.

Document-Related Suppression

Alert generation may be suppressed when retrieved documents cannot support encounter inference.

Examples include:

Documents that lack required encounter-level elements.
Documents with invalid or incomplete patient references.
Administrative, financial, scheduling, or eligibility-related documents.
Unstructured or incomplete documents that cannot be parsed into meaningful encounter data.

Successful document retrieval alone does not guarantee alert generation.

Enrollment Timing Rules

Enrollment is evaluated prospectively.

Alerts are generated only if the patient is enrolled when qualifying document retrieval and analysis are processed within an active observation window.
Enrolling a patient after document retrieval and analysis have completed does not generate an alert for prior activity.
Removing a patient from enrollment prevents alerts for subsequent qualifying activity after propagation completes.

Enrollment does not initiate document retrieval and does not generate alerts on its own.

Source and Network Considerations

Clinical Alerts depends on document exchange across participating organizations.

If participating organizations do not exchange clinical documents for an encounter, no alert can be generated.
Alert generation reflects observed document availability, not the occurrence of care itself.
Document activity that cannot be associated with an enrolled patient at the time processing occurs does not generate an alert.

Clinical Alerts is designed to surface awareness of patient care activity, not administrative or operational transactions observed on the network.

Timing and Delay Considerations

Alert generation and delivery are event driven and asynchronous.

Delays may occur due to:

Source system timing in making documents available.
Network transmission behavior.
Document parsing and inference processing time.

Alerts may be delivered hours or, in some cases, days after the underlying care event. Ordering relative to other clinical events is not guaranteed.

Alerts are not re-emitted for previously processed activity.

Limitations

Clinical Alerts provides situational awareness based on observed document exchange activity.

It does not:

Replace HL7 v2 ADT messages.
Guarantee detection of all patient encounters.
Deliver full clinical documents.
Provide real-time source-system event signaling.