Alert Rules
Clinical Alerts function through a structured observation window that governs when an alert is generated and when it is suppressed.
Observation Window
The window begins when a qualifying network query is detected and remains active for up to 10 days. Document retrieval and analysis must complete within this period for an alert to be generated. If no qualifying documents are evaluated within the window, no alert is produced.
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 the following conditions align:
- Patient is actively enrolled for Clinical Alerts at the time processing occurs.
- A qualifying network query is detected for that patient.
- One or more clinical documents are successfully retrieved and evaluated.
- Retrieved content contains sufficient clinical context to support encounter inference.
- Analysis completes successfully within the active observation window.
Document-Related Suppression
Alerts are not generated when:
- Documents lack encounter-level elements required for inference.
- Documents contain only administrative, financial, scheduling, or eligibility content.
- References within the document are invalid or unresolvable.
- Some unstructured or incomplete documents do not contain sufficient information to support encounter inference.
Enrollment Timing
Enrollment is evaluated prospectively. A patient must be enrolled at the moment activity is processed. Enrolling a patient after document retrieval and analysis have completed does not generate an alert for prior activity, and alerts are not re-emitted for previously processed activity.
Source and Network Considerations
Alert generation depends on actual document exchange between organizations on participating networks and reflects observed document availability rather than the occurrence of care itself.
Alert Processing and Delays
Alert generation and delivery are event-driven and asynchronous. Notifications are typically delivered in 4 to 24 hours, but timing is ultimately depends on source-system processing, network transmission, and document analysis. Strict ordering between clinical events is not guaranteed.
Delays may occur due to:
- Source system timing in making documents available.
- Network transmission behavior.
- Document parsing and inference processing.
Limitations
Clinical Alerts provides situational awareness based on observed document exchange activity. It does not replace HL7 v2 ADT messages or guarantee detection of all patient encounters, and it should not be used as the sole source of truth for clinical activity.