Delivery and Payloads

After alert generation, delivery configuration determines how the notification is transmitted to your system. Detection logic and alert eligibility are independent of delivery method and payload format.

Clinical Alerts supports two delivery methods:

• FHIR Subscription (REST-hook)
• Secure File Transfer Protocol (SFTP)

Only one delivery method may be configured per tenant.

FHIR Subscription (REST-hook)

When configured for FHIR Subscription delivery, Health Gorilla sends notifications to your system using REST-hook transport.

Under this model:

• Health Gorilla sends an HTTP POST request to your configured HTTPS endpoint.
• Your system must return a 2xx status code to acknowledge receipt.
• Non-2xx responses are treated as delivery failures and may result in retry attempts. Retry behavior follows configured delivery policies and does not guarantee eventual delivery.

The notification payload is represented using FHIR structures and includes inferred encounter context within a Parameters resource.

FHIR Payload Structure

FHIR-based notifications include a Parameters resource that contains an embedded Encounter resource representing inferred clinical activity.

The embedded Encounter provides context such as:

• Encounter class
• Encounter timing
• Patient reference
• Facility or organization context

This encounter represents document-derived activity and should not be treated as an authoritative or complete source-system encounter record.

Example FHIR Payload

{
  "resourceType": "Parameters",
  "parameter": [
    { "name": "eventType", "valueString": "clinical-alert" },
    {
      "name": "encounter",
      "resource": {
        "resourceType": "Encounter",
        "id": "1234567",
        "class": { "code": "IMP" },
        "subject": { "reference": "Patient/98765" }
      }
    }
  ]
}

Secure File Transfer Protocol (SFTP)

When configured for SFTP delivery, notifications are transmitted as files to your designated SFTP location.

Under this model:

• Alert files are written to the configured destination.
• Each file represents a generated notification.
• Your system is responsible for ingesting, monitoring, and processing delivered files.
• Delivery confirmation is based on successful file transfer, not HTTP acknowledgment.

SFTP delivery does not use FHIR-based webhook payloads. When configured for HL7 v2 delivery, notifications are transmitted as HL7 v2 A08 messages.

HL7 v2 A08 Payload

The A08 message type is used to communicate encounter update information. The payload communicates encounter-level context consistent with the FHIR-based representation. It does not include full clinical documents.

Key segments may include:

• MSH: Message header and message control identifier
• PID: Patient identification information
• PV1: Encounter-level details such as class and facility context

Example HL7 v2 A08 Message

MSH|^~\&|HG|HG|CLIENT|CLIENT|202401011200||ADT^A08|123456|P|2.5
PID|1||98765^^^HG||DOE^JANE||19800101|F
PV1|1|I|||^^^St. Mary Hospital||||||||||||1234567

Accessing Clinical Documents Through Patient360

Clinical Alerts does not retrieve or deliver clinical documents. When an alert indicates activity that requires review, your organization may use Patient360 retrieval workflows to access available clinical documents.

Document availability depends on network participation, source behavior, and retrieval configuration. Not all alerts correspond to retrievable documents. Alert processing should not assume document availability.

Responsibilities

Your organization is responsible for:

• Configuring and maintaining the selected delivery endpoint.
• Monitoring endpoint health or file ingestion.
• Acknowledging FHIR Subscription deliveries with a 2xx response.
• Implementing idempotent processing to handle potential retries.
• Routing alerts to appropriate downstream workflows.

Health Gorilla is responsible for:

• Generating notifications when qualifying activity is detected.
• Transmitting alerts using the configured delivery method.