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The Enginev1

Gastroenterology

DEMO-03 — Positive Screening Without Completed Diagnostic Follow-up

Authored demonstration. Not a live employer result.

01 · Situation

The referral was placed. Ninety days later, neither system shows what happened to it.

An illustrative positive stool-based colorectal screening test triggers a required diagnostic colonoscopy referral. The referral is placed; the procedure is never completed.

02 · Evidence

What the record holds.

  1. E0Illustrative referral-management protocol, assigning GI scheduling responsibility to schedule the referral or, if unscheduled, document non-completion and initiate recall within 60 days

    Verified · On file prior to Day 0

  2. E1Positive screening result

    Verified · Day 0

  3. E2Diagnostic colonoscopy referral placed

    Verified · Day 2

  4. E3Scheduling system reviewed through Day 90; no completed or cancelled appointment found

    Verified · Day 90

  5. E4Patient-recall log reviewed through Day 90; no recall contact attempt recorded

    Verified · Day 90

03 · Obligations / Owners

The chain of responsibility.

  1. 01

    GI scheduling (schedule the referral, or document non-completion and initiate recall, within 60 days per E0)

04 · Accountability Break

Where the chain broke.

Neither a scheduled disposition, a cancellation, nor a recall attempt appears in the reviewed repositories by the 60-day deadline E0 establishes.

05 · Next Action

The corrective obligation.

Any referral unscheduled past 60 days triggers an automatic recall-contact requirement, logged as its own artifact.

06 · Economic Boundary

Where the evidence stops.

Not established.

07 · Engine Answer

What the Engine can and cannot establish.

GI scheduling was required, under the referral-management protocol named in E0, to schedule the referred colonoscopy or document non-completion and initiate recall within 60 days. The scheduling system and the recall log were both reviewed through Day 90, and neither shows a scheduled disposition, cancellation, or recall attempt. The Engine can demonstrate that the obligation E0 assigns to scheduling was not demonstrably fulfilled. The procedure's ultimate completion or non-completion is an observed downstream state, not something scheduling was responsible for guaranteeing. It cannot establish why scheduling never acted, or whether the patient independently sought care outside these repositories.

The referral was placed. Ninety days later, neither system shows what happened to it.