Endocrinology
DEMO-05 — Abnormal Result Without Acknowledgement, Assigned Follow-up, or Disposition
Authored demonstration. Not a live employer result.
01 · Situation
Abnormal Result Without Acknowledgement, Assigned Follow-up, or Disposition
An illustrative significantly abnormal diabetes-related lab result routes to a clinical inbox. The obligation tested here is the acknowledgement-and-disposition step itself — not a specific treatment decision, which may or may not be the eventual right action.
02 · Evidence
What the record holds.
- E0Illustrative inbox-management policy, requiring acknowledgement and disposition of any routed result within 10 days
Verified · on file prior to Day 0
- E1Abnormal lab result routed to clinical inbox
Verified · Day 0
- E2Inbox acknowledgement log reviewed through Day 10; no acknowledgement entry found for this result
Verified · Day 10
- E3Care-team task-assignment system reviewed through Day 10; no follow-up task created
Verified · Day 10
- E4Patient chart reviewed through Day 10; no disposition note of any kind entered
Verified · Day 10
03 · Obligations / Owners
The chain of responsibility.
- 01
Receiving clinician (acknowledge the result and produce some disposition within 10 days, per E0)
04 · Accountability Break
Where the chain broke.
None of the three reviewed repositories — acknowledgement log, task system, or chart — shows any response at all to this result by Day 10.
05 · Next Action
The corrective obligation.
Require a disposition entry of some kind (not necessarily treatment) within the E0 window; silence past that window triggers escalation.
06 · Economic Boundary
Where the evidence stops.
Not established.
07 · Engine Answer
What the Engine can and cannot establish.
The receiving clinician was required, under the inbox-management policy named in E0, to acknowledge the result and produce some disposition within 10 days — not necessarily to initiate treatment, since treatment may not have been the correct response. The acknowledgement log, task system, and chart were each reviewed independently through Day 10, and none shows any response. The Engine can demonstrate that the result received no documented acknowledgement, assignment, or disposition of any kind. It cannot establish whether the clinician reviewed it informally, whether treatment was or wasn't clinically indicated, or why no record exists in any of the three repositories.
The result arrived. Nothing in any reviewed record shows anyone responded to it.