📏Routing Rules

Routing rules determine the escalation levels for your critical alerts

1. How do routing rules work?

2. Creating routing rules

3. Can I bypass manual intervention for specific results?

4. Configuration for skipping Ordering / Attending doctors who are on leave

5. Modifying / Disabling your routing rules

6. Exporting your routing rules into excel

Routing rules

Routing rules are configured to decide which clinician / staff should be alerted about their critical results. They can only be configured by the superuser role as mentioned here.

To determine which routing rule to activate for each critical result, the system selects the rule that most closely matches the patient's location and specialty based on ADT/Results HL7 messages as seen here. E.g We will escalate any critical results of patients who are from specialty : KSA&E and location : KCA&E to the ordering doctor (OD) by activating the routing rule shown below.

An example of a routing rule

This logic does not apply if your routing rule is directly linked to a result filter. For more details on how to set this up, refer here .

How are patient specialty and location obtained for escalation ?

Inpatient patients

For inpatient patients, the system determines the patient's specialty and location using the following steps:

1. Latest ADT by Patient UIN:

   • Retrieve the latest ADT record received immediately before the result, using the patient's UIN.

   • If found, use the patient's location, specialty, and attending doctor from this record.

2. ADT by Visit Number:

   • If no ADT is found using the UIN, search for an ADT record using the visit number (which is generated per admission).

   • If found, use the patient's location, specialty, and attending doctor from this record.

3. ORU HL7 Results Message:

   • If no ADT records are found in steps (1) and (2), extract the patient's location, specialty, and attending doctor from the ORU HL7 results message.

Outpatient patients

For outpatient patients, the system determines the patient's specialty and location using the following steps:

1. ADT by Visit Number:

   • Search for the latest ADT using the visit number (which is generated per admission).

   • If found, use the patient's location, specialty, and attending doctor from this record.

2. ORU HL7 Results Message:

   • If no ADT is found in steps (1), extract the patient's location, specialty, and attending doctor from the ORU HL7 results message.

Creating routing rules

1. Create a new routing rule by clicking on '+ Create New Rule.' This should trigger a pop up to appear where you can create your own rule.

1. Fill in the Rule Details :

   • Name : Enter a descriptive name for the rule (e.g., "Catch All Routing Rule").

   • Specialties : Select at least one specialty from the dropdown menu.

   • Locations : Select the relevant location(s) where this rule will apply.

   • Interval Before Next Escalation : Set the time (in minutes) before escalation from P1 to P2 (max: 60 minutes).

   • Office Hours : Define the timings for "During Office Hours" for Mon-Fri , Sat and Sun & PH.

     • Your start and end time should tally with the start and end time of your shift.

     • If there are no office hours for Sun&PH , you can set the start and end time to be the same to reflect the 24h shift. Select the "Use the same rules as "During Office Hours"" checkbox for this use case.

2. Configure the escalation logic for during and after office hours :

   • Escalation Options:

     • Roles: Escalate to Ordering Doctor (OD), Attending Doctor (AD), or both.

       • OD is retrieved from results HL7 message, specifically : LIS & others - OBR 16.1 || Beaker & RIS - ORC 12.1 .

       • AD is retrieved from ADT HL7 message. Specifically, we will follow the logic here to retrieve the AD.
     • Contacts: Escalate to specific contacts from the directory. For instance there are some specialists who need to be aware of all the critical alerts from a certain specialty.

     • Rosters: Escalate based on On-Call / Team Roster (select column and rows).

     • AD Team Rosters: Find the incoming AD's team

       • E.g, based on the routing rule shown below, Rooster will first identify the monthly roster name and the role specified in the rule. It will then locate the assigned AD — for example, Dr Eric Wong — and determine which team they belong to (e.g. KTPH ASU). Finally, Rooster will escalate the result to the doctor assigned to the specified role within the same team — in this case, Dr Clem, who is rostered under the HO role.

       

       
   • Escalation levels:

     • These are the different levels of escalation i.e we will first escalate the critical alert to P1 then P2 and P3. The timing between each interval can be customised using 'Interval before next escalation.'

     • All users in each escalation level will be notified simultaneously

   • If you have the same escalation logic for during and after office hours, you can tick "Use the same rules as "During Office Hours"".

   

It is recommended to configure a 'catch-all' rule by selecting 'All Specialties' and 'All Locations'. This ensures that any critical results will always be escalated even if it has an unknown specialty/location.

Skipping manual intervention

If you would like to configure results to be automatically closed by Rooster instead of escalated to a contact centre staff, select 'Skip Manual Intervention.'

In this scenario, the escalation interval is set as 10 minutes.

• Sample routing rule to skip manual intervention:

  

  Routing rule where "Skip manual intervention" is selected.
• How escalations will look like

  

  Case is automatically closed by system as P1 contact was not found

1. Once you have finished configuring your routing rules, click on the 'Save' button to save your progress.

If you new routing rule overlaps with an existing rule in terms of location and specialty, you won't be able to save it and will see an error message:

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Configuration for skipping Ordering / Attending doctors who are on leave

You can configure Rooster to automatically skip Ordering (OD) and Attending (AD) doctors if they are on leave when a critical result is triggered.

To configure:

1. Go to the relevant Routing Rule.

2. Scroll to the "Skip doctors who are on leave" setting.

3. Toggle the setting ON or OFF depending on your preference. [It is enabled by default]

Note: The doctor will only be skipped if they meet ALL the conditions as follows:

• They are an ordering or attending doctor in the critical result.

• They have been assigned to a leave roster and are on 'Full day' leave.

• They are on leave within the office hours defined in the routing rule.

  • E.g, If a doctor is on leave on 5 May, and a critical result arrives on 6 May at 7:30am (before office hours), they will still be skipped, as the system treats the trigger time as part of 5 May.

If your routing rule only includes OD/AD and skips manual intervention and both are on leave, the result will be closed automatically by the system, no clinician will be notified. E.g, 'Routing Rules for R1U / Unexpected radiology results.

Modifying / Disabling routing rules

1. To edit your routing rules , navigate over to three dots and select 'Edit routing rules' from the dropdown menu. If you select 'Edit routing rule' it will direct you to Creating routing rules again.

1. If a routing rule is not longer in use , you have the option to disable it. Click on 'Disable routing rule'. An alert pop up will be triggered to confirm this action. Once verified, click on 'Disable'

2. Its status will be updated as 'Inactive.'

1. You have the option to 'Enable Routing Rule' again by clicking on the three dots again. Again , an alert pop up should be triggered to confirm if you would like to enable this filter

Exporting your routing rules

• If you would like to export your routing rule, you can click on 'More' to export your routing rule in an excel format.