Signature queue
Nothing the platform generates enters the record without a human signature — and nothing is signed from a list row. Each draft opens into a full review where the complete text can be read, rewritten, signed or declined. The blocked row is not styling: Epic exposes no REST write for MedicationRequest, so the platform refuses rather than degrades — that draft opens to a hand-off and a decline, not to a sign button it could not honour.
| Draft | Patient | Target write API | State | Action |
|---|---|---|---|---|
| Ambient note — endocrinology follow-up
Structured from an 18m 41s recording; 3 candidate findings carry their transcript spans
|
Vladimir Semyon Gomez | DocumentReference create — api=1046 | staged, unsigned | Review & sign → |
| Vital signs from the ambient encounter
BP, weight, pulse — flowsheet row IDs mapped site-side
|
Vladimir Semyon Gomez | Observation create Vital Signs R4 — api=963 | staged, unsigned | Review & sign → |
| Problem-list addition — diabetic nephropathy
Raised by documentation-gap detection; supported by the cited lab pattern
|
Mariana Gomez | Condition create | staged, unsigned | Review & sign → |
| Medication change — metformin 1000mg → 500mg BID
Cannot be written. Epic exposes read and search only for MedicationRequest
Epic exposes MedicationRequest as read/search only over FHIR REST; order-shaped writes exist only as CDS Hooks 'unsigned order' suggestions |
Nikolai Gomez | no REST create — CDS Hooks unsigned order | blocked — no write path | review → |
Signing writes a signature.committed event to the audit trail; so do the decisions that are not signatures — signature.draft_revised, signature.declined and cds.suggestion_presented. A draft nobody answered is the one state the trail cannot explain, which is why declining is an action here and not an omission.