Document Issues

Health Gorilla parses incoming documents to generate FHIR Encounter resources or HL7 v2 A08 payloads, when configured. If a document is incomplete or malformed, alert generation may be suppressed.

The following types of document issues can result in alert suppression:

• Documents that lack the required Encounter elements
• Documents with invalid or incomplete patient references
• Unstructured document types that cannot be parsed into Encounter events

Source Considerations

Network queries can originate from a variety of organizations and endpoints. Not all document activity observed on national networks results in alert generation.

The following conditions may affect alert generation:

• Documents related to administrative, financial, scheduling, or eligibility workflows rather than clinical care
• Documents that do not contain sufficient clinical content to infer an encounter, such as coverage, billing, or referral coordination artifacts
• Document activity that cannot be associated with an enrolled patient at the time processing occurs

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

Patient Enrollment Changes

Clinical Alerts are triggered only for patients who are actively enrolled at the time qualifying document activity is processed.

The following enrollment-related behaviors affect whether alerts are generated.

• If a patient is enrolled but later removed, alerts are not generated for subsequent qualifying document activity.
• If a patient is enrolled after a document has already been retrieved, no retroactive alert is generated.

You should monitor enrollment lists regularly and coordinate enrollment updates with downstream workflows.

Delayed Alerts

Alerts are delivered based on document availability, processing conditions, and network behavior.

The following factors can introduce delays in alert delivery:

• Documents may become available hours after the originating network activity, depending on source system behavior
• Parsing and Encounter generation may take additional time if document content requires review
• Alerts may be delivered several hours later and, in some cases, up to a day after the triggering activity

If you observe delays that appear inconsistent with expected network behavior, contact Health Gorilla for investigation.