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Ryan GomezRole
Signed in — Ryan Gomez · System Administrator
You stay on this screen — each role sees it as their own permissions allow. The assistant thread and the patient in context start fresh.
Working archetypes — combinations people really hold
One role at a time — each role on its own
DocumentationDocs
System documentation Implementation & setup guide Feature documentation Model documentation System architecture EMR connections Emulators & non-PHI setup Compliance & responsibility Attribution
Repository

Streaming export manager

Data leaving in real time — ADT notifications to community providers, results to the patient portal, claims to the clearinghouse, measure submissions. Each outbound feed tracks what the destination has acknowledged against what has been produced; the difference is held and accounted, never dropped, and a feed can be paused by governance without losing its place.

5,110
deliveries today across all feeds
182
held for retry — queued and accounted, not dropped
5
outbound feeds under acknowledgment discipline

Outbound feeds

FeedDestinationAcknowledged ProducedHeld TodayLast deliveryState
ADT notifications (CMS Condition of Participation) Community providers via HIE 6,621,401 6,621,401 0 1,188 13:58 healthy
Results to patient portal Patient portal 3,310,221 3,310,221 0 3,301 13:59 healthy
Claims 837 submissions Clearinghouse 441,207 441,389 182 206 11:02 held
Clearinghouse rejecting since 11:02 (certificate rotation on their side). 182 submissions HELD with retry - held means queued and accounted, never dropped; nothing is re-generated or skipped.
Quality-measure submission (eCQM) Payer portal 8,812 8,812 0 3 09:15 healthy
Event notifications to researchers De-identified event bus 99,120 99,120 0 412 13:57 paused
Paused by governance: purpose-of-use review of a new subscriber in progress. A paused feed accumulates sequence, it does not leak.
Outbound is governed like inbound. A held feed retries against the destination without regenerating or skipping; a paused feed is a governance decision that accumulates sequence rather than leaking; and nothing in a de-identified event feed carries identifiers — the pause in the table above is a purpose-of-use review doing its job.