Preconditions

Before enabling all-tenant group enrollment, verify that the following conditions are met:

• Delivery configuration is complete and the endpoint has been validated.
• Patient data ingestion is functioning for the tenant.

All-tenant membership is system-managed, so no client-side API configuration is required.

Enrollment Configuration

All-tenant group enrollment is configured and managed by Health Gorilla. Your organization does not create or manage a FHIR Group directly under this model.

After prerequisites are met, enabling all-tenant group enrollment consists of the following actions:

• Confirm enrollment intent for all patients in the tenant.
• Health Gorilla enables system-managed enrollment for the tenant.
• Confirm alert generation and delivery for a known patient before relying on full coverage.

Once enabled, enrollment applies automatically to existing and newly available patients.

How All-Tenant Enrollment Works

Under all-tenant group enrollment, Health Gorilla maintains a system-managed FHIR Group that includes all patients associated with the tenant. Patient membership is derived automatically and updated as patients become available.

Your organization cannot explicitly add or remove individual patients under this model. Alert eligibility remains tied to tenant-level patient availability.

Confirm Enrollment

Before relying on all-tenant enrollment, confirm that alert generation and delivery are functioning as expected.

To validate enrollment effectiveness:

• Verify that alerts are generated for qualifying document activity involving a known patient in the tenant.
• Confirm that alerts are delivered successfully to your configured endpoint.

Enrollment changes apply prospectively. Allow several minutes for configuration changes to propagate before validating alert behavior.

Enrollment Behavior and Constraints

The following behaviors apply when using all-tenant group enrollment:

• Enrollment is evaluated at the time qualifying document activity is processed.
• Enrollment changes apply prospectively and do not affect previously processed activity.
• New patients are enrolled automatically once they are available in the tenant.
• Individual patients cannot be selectively unenrolled.
• Removing a patient from the tenant stops alert generation for that patient after propagation completes.
• Alert payloads and delivery behavior are unchanged once enrollment is active.

Only the all-patients characteristic is used for Clinical Alerts enrollment. Other characteristic-based enrollment is not supported.

Transition to Limited Group Enrollment

Some organizations transition from all-tenant group enrollment to limited group enrollment in order to restrict alert eligibility to a specific patient population.

Because all-tenant enrollment is system-managed, this transition requires coordination with Health Gorilla. Limited group enrollment must be configured and validated before all-tenant enrollment is disabled to avoid gaps in alert coverage.

To transition safely:

• Configure limited group enrollment and populate the group with the initial set of patients.
• Validate that alerts are being generated and delivered for patients in the limited group.
• Request that Health Gorilla disable all-tenant group enrollment for the tenant.

Once all-tenant enrollment is disabled, alert generation continues only for patients included in the limited enrollment group.

Enrollment evaluation remains prospective throughout the transition. Alerts are not generated retroactively for patients added to the limited group.