Alert Payload Structure

When Clinical Alerts are delivered using FHIR Subscription or SFTP delivery, the notification payload may be represented using FHIR-based structures, including a FHIR Parameters resource. The payload identifies the alert event and includes an embedded Encounter resource representing the detected clinical activity.

The embedded Encounter provides encounter-level context, such as encounter type, timing, patient reference, and facility information. This context is sufficient for alert processing even when no clinical document is available.

Example Payload

{
  "resourceType": "Parameters",
  "parameter": [
    { "name": "eventType", "valueString": "clinical-alert" },
    {
      "name": "encounter",
      "resource": {
        "resourceType": "Encounter",
        "id": "1234567",
        "status": "in-progress",
        "class": { "code": "IMP" },
        "type": [{
          "coding": [{
            "system": "http://terminology.hl7.org/CodeSystem/encounter-type",
            "code": "inpatient",
            "display": "Inpatient encounter"
          }]
        }],
        "subject": { "reference": "Patient/98765" },
        "period": { "start": "2024-12-10T08:00:00Z" },
        "location": [{ "location": { "display": "St. Mary Hospital" } }]
      }
    }
  ]
}

Encounter Context in Alerts

The Encounter included in the alert payload represents inferred clinical activity based on document exchange observed across national health information networks. The encounter reflects the context of the activity, not a guaranteed or complete source-system encounter record.

Your system can use this encounter context to:

• Identify the type and timing of patient activity.
• Correlate the alert with internal workflows or patient records.
• Decide whether follow-up access through record retrieval is appropriate.

Accessing Clinical Documents Through Patient360

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

When a qualifying document is available, the inferred encounter may reference a related DocumentReference. Document availability depends on source behavior, network access, and document type.

If document access is required, use Patient360 APIs to retrieve the document based on the referenced identifiers and your organization’s retrieval configuration.

Not all alerts include associated documents. Alert processing should not assume document availability.

HL7 v2 A08 Payloads

When Clinical Alerts is configured to generate HL7 v2 A08 payloads, Health Gorilla produces a synthetic encounter update derived from document-driven activity.

The HL7 v2 A08 payload represents the same inferred encounter context as the FHIR-based payload, expressed in HL7 v2 format. The payload includes an encounter identifier that your system can use to correlate the alert with downstream workflows or initiate record retrieval through Patient360, when appropriate.

The delivery method used to transmit the payload is independent of the payload format.

Using Alert Context

After receiving an alert, your system can use the provided context to:

• Associate the alert with internal patient records.
• Trigger downstream clinical or operational workflows.
• Apply deduplication or reconciliation logic.
• Determine whether record retrieval through Patient360 is required.

Clinical Alerts are event driven and prospective. Previously processed encounters and documents are not re-emitted as alerts.