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Alert workflow for abnormal pre-op lab results

Purpose

1.1. Real-time detection of abnormal pre-op lab results to minimize perioperative risk, enable timely interventions, and support clinical decision-making.
1.2. Enhance patient safety by immediately notifying care teams of critical lab abnormalities before anesthesia induction.
1.3. Streamline communication between lab, anesthesia, and surgical staff for effective patient management in perioperative settings.
1.4. Reduce manual chart review workload for anesthesiologists by ensuring only exceptions reach their attention.

Trigger Conditions

2.1. Abnormal pre-op lab value returned in EMR/LIS (e.g., CBC, INR, potassium).
2.2. Results flagged as outside institution-specific safety ranges or marked “critical” by lab system.
2.3. Results associated with a scheduled procedure within 24–72 hours.
2.4. New result posted to patient’s record after last clinical review.

Platform Variants

3.1. Twilio SMS
• Feature: Programmable Messaging — configure alert rule using webhook for abnormal results, template: “URGENT: Patient [ID] has abnormal [Lab Name]: [Value].”
3.2. SendGrid
• Feature: Transactional Email API — setup automated email alert to designated anesthesiology list with full lab and patient context.
3.3. Slack
• Feature: Incoming Webhooks — deliver JSON payload of lab alert to anesthesia staff channel.
3.4. Microsoft Teams
• Feature: Connector — configure channel notification for abnormal results; use adaptive cards for structured data.
3.5. PagerDuty
• Feature: Events API v2 — trigger on-call alert with incident details for urgent lab issues.
3.6. ServiceNow
• Feature: Incident Management API — automatically open ticket and assign to clinical team lead.
3.7. Atlassian Jira
• Feature: Issue Create API — generate critical incident in anesthesiology board with patient and lab details.
3.8. Salesforce Health Cloud
• Feature: Case Management — auto-create clinical case using REST API when triggered by flagged results.
3.9. Cerner Millennium
• Feature: FHIR Subscription — subscribe to Observation resource for abnormal lab results events.
3.10. Epic Systems
• Feature: Interconnect API/HL7 FHIR — pull lab results, push alert via secure messaging within hyperspace.
3.11. Google Chat
• Feature: Incoming Webhooks — post structured alert message to care team room with patient and result.
3.12. WhatsApp Business API
• Feature: Template Message — send instant alert using medical-approved template to anesthesiologist mobile.
3.13. Cisco Webex
• Feature: Bot Message API — deliver abnormal result info to group chat of surgical support team.
3.14. Splunk
• Feature: HTTP Event Collector — log structured abnormal result events for incident detection dashboards.
3.15. AWS SNS
• Feature: Topic — configure subscription for alert; invoke Lambda to process and route abnormal events.
3.16. Azure Logic Apps
• Feature: Automated Workflow — connect to hospital EMR, filter for triggers, send alert email/SMS as appropriate.
3.17. Google Cloud Pub/Sub
• Feature: Topic — publish new abnormal lab event; downstream subscriber sends notification to on-call.
3.18. Zendesk
• Feature: Ticket Create API — open support ticket for abnormal result; assign to perioperative coordinator.
3.19. Freshdesk
• Feature: API Ticket Trigger — create high-priority case for perioperative team action and tracking.
3.20. Meditech Expanse
• Feature: Patient Event Notifications — configure abnormal result triggers and instant email/pager alerts.

Benefits

4.1. Ensures rapid response to clinical hazards, improving perioperative outcomes.
4.2. Reduces delays or cancellations due to missed critical labs.
4.3. Automates escalation process to appropriate clinical or operational stakeholder.
4.4. Provides audit trail for all alert events, supporting compliance and QI efforts.
4.5. Maximizes staff efficiency by filtering out in-range results and focusing attention only when needed.

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