Smart Notification Feature
Status: Requirements In Progress ready for Work
Technical Complexity: Easy Medium Hard / Complex
Summary:
Automatically notify clinicians when ordered lab tests are ready, so they stop manually tracking pending tests and patients don’t wait unnecessarily.
Picture showing what this project is about (e.g. a key mockup, drawing; anything visual)
1. Problem
When a clinicians order laboratory tests during a consultation, they have no automated way to know when results become available. This absence places the burden on clinicians rather than on the system, leaving patients in limbo. Without this feature, clinicians must:
Manually track which patients have pending lab orders
Periodically check the system for new results
Have no way to distinguish urgent results from routine results without manually reviewing each one
Interrupt current patient consultations to check on the previous patient’s results
Delay reviewing results and providing subsequent patient care
Risk missing follow-up on the tests ordered, especially during busy clinic sessions
Meanwhile, patients who have completed their lab tests experience uncertainty and delays:
Don't know when their results are ready
Experience anxiety about being forgotten in the system
Make difficult decisions about whether to wait at the facility or leave
Face extended wait times as clinicians juggle manual tracking
Experience delayed diagnosis and treatment when results are time-sensitive
The fundamental problem: Clinicians want to focus on delivering patient care, not on tracking status updates. Yet the current system forces them to do both.
Simply sending notifications for every lab result may create a different problem….notification overload
Important results may be buried in the noise
Clinicians may end up ignoring notifications due to alert fatigue
Critical alerts may be missed because clinicians become desensitized to constant notifications
Defeats the entire purpose of the notification system
The Right Solution: Notification Filtering
What clinicians actually need is an intelligent "push" model that automatically notifies them when priority results become available, while keeping routine results accessible without causing interruption.
Smart Notification Filtering Based on Clinical Priority:
✅ DO Notify (Requires Attention)
STAT/URGENT Orders → Always notify
Reason: Clinician is actively waiting for the result/s to make treatment decisions
Critical/Dangerous Values → Immediate notification
Reason: Life-threatening findings require immediate action
❌ DON’T Notify (Can Wait)
Routine Normal Results → No interruption needed
Slightly Abnormal Results → No interruption needed
Expected Abnormal Results → → No interruption needed. For example, a patient with kidney disease always has elevated creatinine.
2. User Stories
USE CASE 1: Lab Results Notification
Scenario: Clinician orders lab tests and receives notification only when laboratory results require immediate clinical attention.
Dr. Smith orders a lab test for patient John Doe, specifying the order priority (e.g., STAT vs. Routine).
The EMR transmits the order to the laboratory queue.
The lab technician processes the sample and publishes the final results back to the EMR.
Before triggering any alerts, the system intercepts the result and applies a Clinical Priority Filter.
High-Priority Trigger: IF the original order was marked STAT/Urgent, OR IF the result contains a Critical Value (e.g., life-threatening), THEN the system executes an Immediate Push Notification to Dr. Smith..
Routine-Priority Trigger: IF the order was Routine, AND IF the results are Normal or only Slightly Abnormal (within non-critical thresholds), THEN the system Silently Updates the patient’s chart. No push notification is generated.
Dr. Smith manages her workflow based on the filtered output:
For High-Priority Alerts: She receives an intrusive notification (e.g., “⚠️ CRITICAL: John Doe - Potassium 2.2”) and clicks it to immediately initiate a life-saving intervention.
For Routine Results: She reviews the updated chart during her scheduled rounding or administrative time, ensuring her current patient care is not disrupted by non-urgent data.
User Story:
As a Clinician, I want to receive immediate 'push' notifications only for critical or STAT results, so that I can intervene on life-threatening findings instantly while reviewing routine results at a more appropriate time without interruption.
As a Lab Technician, I want the EMR to intelligently categorize the results I enter, so that urgent clinical findings are escalated to the provider immediately, ensuring that my technical work leads to the fastest possible clinical response.
As a Patient, I want the system to prioritize my doctor’s attention toward my most urgent health data, so that I receive immediate care for critical issues while knowing my routine results are being managed safely in the background.
USE CASE 2: Prescription Changes
Scenario: Patient arrives at pharmacy with prescription that requires modification.
The patient presents a prescription to the pharmacy.
The pharmacist identifies an issue with Jane Doe’s prescription (Metformin 1000mg) and requests a modification through the system. (e.g., dosage concern, drug interaction, or out-of-stock)
IF Reason = "Drug Interaction Detected" or "Allergy Conflict" or Dosage concern, THEN the system Trigger Immediate Push Notification.
Alert: "⚠️ SAFETY ALERT: Jane Doe - Metformin interaction with [New Med]. Action required."
The system immediately sends a notification alert to the prescribing clinician. Dr. Smith sees the pop-up immediately, reviews the interaction, and sends a safe alternative to the pharmacy in real-time.
Message: Prescription modification requested by Pharmacy for Jane Doe - Metformin 1000mg. Reason: Drug interaction detected.
Approves modification → System notifies pharmacy immediately
Rejects/modifies differently → System sends alternative prescription to pharmacy
User Story:
As a Pharmacist, I want the system to automatically escalate (notify the clinician immediately) high-priority safety concerns (like drug interactions or allergies) to the prescribing clinician so that I can resolve medication safety issues quickly and reduce patient wait time at the pharmacy.
As a Clinician, I want the EMR to interrupt me for clinical safety risks or urgent medication changes, so that I can prevent medical errors, ensuring my patient receives safe and appropriate medication without delay.
As a Patient, I want the most urgent issues with my medication to be prioritized for my doctor's immediate attention, so that I am protected from dangerous drug conflicts.
As a Pharmacist, I want to be notified when a clinician has resolved a pending modification, so that I can finalize the dispensing process as soon as the clinical 'block' is removed.
3. Market Analysis
System | Features | Remarks |
|---|---|---|
Prognosis: https://youtu.be/0d4QXIU07uc |  |
|
OpenMEMR: https://demo.openemr.io/openemr/interface/login/login.php?site=default (admin/pass) | |
|
DrChrono: https://youtu.be/3PT1ViGDnss |
|
|
|
|
|
4. Technical Considerations & Dependencies
Notification trigger mechanism → Should this be via event module?
Check events ~ Lab result created
Intercepts the event, checks the STAT flag or Critical Value thresholds, and determines the "Acuity Level
Notification storage → is this needed?
Audit trail of who was notified, when, and if they took action?
WHEN to notify? → Backend trigger ~ notification hook ~ detects the event?
HOW to notify? → Delivery mechanism ~ Push notifications ~ Frontend ~ doctors get to see the message ~ client side
Notification UI component → Notification Center/Inbox for New/Unreviewed messages (basic inbox UI for MVP)
Notification recipients →
REST API for fetching notifications? → Pagination
Notification status → Ability to mark the message as reviewed (mark notification as read/reviewed)
Performance considerations ???
5. Sketches
Clinician Facing | Lab Facing |
|---|---|
Order with STAT Priority Notification when the STAT order returns a critical value Notification Details | Lab order received
Lab order processing and result entry completed in the Lab
|
PIH Draft Requirements
Requestor: Sierra Leone and Haiti
Problem: Clinicians don’t have easy way to know when a patient’s lab test results are entered in to the EMR and available to view. They currently need to navigate to the patient chart and continuously check the Lab Results page.
Proposal: When lab results are entered, notify the ordering clinician in the EMR.
Details:
Notification icon in the header
If there are unread notifications, an alert should appear with the number of unread notifications
Clicking on the notification icon should open the list of unread notifications
Clicking on a notification should take you to that patient’s lab results page
Once a notification is clicked on and you are directed to the patient’s lab results page, you should then have an option to click “Reviewed” this will then mark the notification as Read. We should capture who reviewed the lab result.
Read notifications should not appear in the notification list
The notification should include the date/time, patient name, and that there is a new lab result Should this be one notification per patient? Or one per test if a patient has more than one result?
Notify when the sample is rejected
The notification should only appear where they are ordered. MCOE should be considered one location. If an order is made from an MCOE location it should appear at all MCOE locations.
Also include notifications on the Ward View patient card. The behavior should remain the same, they need to click review in order to clear the notification.
Notifications: