Document Generation & Workflows
Every clinical and administrative event that should produce a document or trigger a
follow-up chain is modeled as a workflow. When an appointment is
created, a patient onboarded, or a claim denied, a chain of connected steps fires
automatically: documents generate from AI-populated templates, human gates ensure
clinical sign-off, tasks route to the right staff, and notifications go out to patients.
The result: no document is forgotten, no follow-up falls through the cracks, and every
output traces back to the event that caused it.
Document templates are AI-generated and human-gated. The platform
drafts each document from chart data in under 30 seconds, then routes it to the
appropriate role for review and sign-off before finalization. Templates are versioned,
org-customizable, and delivered via portal, fax, Direct message, print, or email.
Key Capabilities
Event-Driven Workflow Engine
Workflows fire from platform events: appointment created, encounter signed off, lab
result received, claim denied, patient registered, referral ordered. Each workflow
definition is a chain of typed steps — GenerateDocument,
CreateTask, SendNotification, CheckCondition,
WaitForEvent, HumanGate — that execute in order with
configurable branching on failure. Practices customize trigger conditions and step
configurations without code. A single trigger can spawn parallel sub-chains
(e.g., an encounter sign-off fires both the billing chain and the patient
communication chain simultaneously).
AI-Generated, Human-Gated Document Templates
Twenty-two template types ship out of the box, covering clinical, administrative,
financial, and patient communication documents. AI populates merge fields from chart
data — demographics, diagnoses, medications, lab values, encounter notes —
and generates a draft in under 30 seconds. Every document passes through a
human gate: the appropriate role (provider for clinical docs, biller
for financial docs, front desk for administrative) reviews and signs off before the
document is finalized and delivered. Templates are versioned independently from
workflows so a template update does not require a workflow redeploy.
22 document templates organized by category
| Category |
Templates |
Sign-off Role |
| Clinical |
After-Visit Summary, Progress Note, Referral Letter, Clinical Summary (C-CDA), Discharge Summary, Prior Auth Letter, Return-to-Work Clearance |
Provider (MD/DO/PA/NP) |
| Administrative |
HIPAA Notice, Treatment Consent, Telehealth Consent, CCM/RPM Consent, FMLA Certification, Disability Certification, Records Release Authorization |
Front Desk / MA |
| Financial |
Patient Statement, Good Faith Estimate, Superbill, Appeal Letter, Corrected Claim Cover |
RCM / Biller |
| Communication |
Recall Reminder, Abnormal Results Letter, Welcome Letter |
Nurse / Provider |
Primary Care Scenario Library
Twelve end-to-end workflow scenarios are pre-configured for common primary care
events. Each scenario defines the trigger, every step in the chain, the documents
generated, the human gates required, and the expected completion time. Select a
scenario below to see the full workflow pipeline.
Workflow Instance Tracker
Real-time visibility into every running workflow: which step is current, which gate
is waiting for sign-off, which steps completed or failed. Staff see their pending
gates in the unified task queue alongside denial follow-ups and co-sign requests.
A workflow that stalls at a human gate for longer than the configured timeout
escalates automatically — first to the assignee's supervisor, then to a
practice-wide alert.
Multi-Channel Document Delivery
Documents deliver via patient portal, secure fax, Direct messaging (for C-CDA
exchange), print queue, or email (encrypted link). The delivery method is configured
per template and overridable per instance. Delivery confirmation is tracked:
portal-viewed timestamp, fax confirmation code, Direct message acknowledgment, print
pickup flag. Failed deliveries auto-retry with channel fallback (e.g., fax failure
falls back to portal + SMS notification).
Template Versioning & Org Customization
Every template version is a separate artifact with its own merge-field set, body, and
output format. Practices clone system defaults and customize headers, logos, verbiage,
and merge fields. Version history is auditable: who changed what, when, and why.
Rollback is one click — the previous version becomes current, and any in-flight
documents already generated from the new version are flagged for re-review. Templates
follow the IC versioning scheme: break.feature.bug.buildtimestamp.
Workflow Analytics Dashboard
Metrics on workflow completion rates, average time-to-completion, most common failure
points, document sign-off latency, and delivery success rates. The dashboard
identifies bottlenecks — for example, "FMLA certifications average 4.2 days to
sign-off; assign to PA/NP for faster turnaround" or "Prior auth appeal letters have
a 12% failure rate at the payer submission step; review fax delivery logs." Drill
down by workflow type, persona, time range, or patient cohort.
Technical Highlights
Seven noun-apps compose the document and workflow surface on the IC platform:
DocumentTemplate, DocumentTemplateVersion, GeneratedDocument, WorkflowDefinition,
WorkflowStep, WorkflowInstance, and WorkflowStepExecution. Every entity is
org-scoped, carrying OrganizationID as the Cosmos
partition key and the full four-field audit trail
(LastUpdatedDateTimeUtc, LastUpdatedByUserID,
IsSoftDeletedBool, CreatedDateTimeUtc). Relationships
are enforced by API, not FK constraints, following IC hard rule #14.
Data Model
- DocumentTemplate — org-scoped template definition.
Fields:
DocumentTemplateName200, DocumentTemplateCategoryString50
(Clinical, Administrative, Financial, Communication),
DocumentTemplateTypeString50 (AVS, ReferralLetter, AppealLetter, etc.),
DocumentTemplateBodyHtml (Handlebars template with merge fields),
IsActiveBool, IsSystemDefaultBool,
DocumentTemplateRequiresSignOffBool,
DocumentTemplateSignOffRoleLevelInt.
- DocumentTemplateVersion — versioned template body, separate
artifact from the template definition per IC rule DEC-005. Each version carries its
own
DocumentTemplateVersionBodyHtml and
DocumentTemplateVersionMergeFieldsJson.
IsCurrentVersionBool marks the active version.
- GeneratedDocument — a rendered document instance. References
DocumentTemplate, Patient, Encounter (optional), and WorkflowInstance (optional).
Status lifecycle: Draft → PendingReview → Approved → Signed → Delivered.
Tracks
IsAiGeneratedBool, IsHumanReviewedBool,
GeneratedDocumentDeliveryMethodString20 (Portal, Fax, DirectMessage,
Print, Email), and delivery confirmation timestamps.
- WorkflowDefinition — a workflow blueprint.
WorkflowDefinitionTriggerTypeString50 maps to platform events
(AppointmentCreated, EncounterSignedOff, LabResultReceived, DenialPosted, etc.).
WorkflowDefinitionTriggerConditionJson holds structured conditions
(visit type, payer, diagnosis code). Versioned independently.
- WorkflowStep — an ordered step within a definition.
WorkflowStepTypeString50 enum: GenerateDocument, CreateTask,
SendNotification, CheckCondition, WaitForEvent, HumanGate, ApiCall.
WorkflowStepConfigJson holds type-specific configuration
(template ID, task type, condition logic, notification channel).
IsRequiredBool controls whether failure blocks downstream steps.
- WorkflowInstance — a running workflow. References
WorkflowDefinition, Patient, Encounter (optional), Appointment (optional).
Status lifecycle: Pending → Running → WaitingOnGate → Completed |
Failed | TimedOut | Cancelled. Tracks current step ordinal and trigger context.
- WorkflowStepExecution — execution record for a single step
within a workflow instance. Status: Pending → Running → Completed |
Failed | Skipped | TimedOut.
WorkflowStepExecutionOutputJson captures
generated document IDs, task IDs, or notification receipts.
API Surface
Documents map to FHIR R4 DocumentReference resources at the platform's standard FHIR
API surface. Workflow trigger events are published to an internal event bus; external
integrations subscribe via webhooks with HMAC-SHA256 signing. The template rendering
engine accepts Handlebars syntax with a curated set of helpers (date formatting,
medication list rendering, diagnosis grouping). AI draft generation uses the platform's
ambient-AI pipeline with the same provenance chain as Clinical Documentation —
every merge-field value traces to a source fact in the patient record.
Cross-Module Dependencies
- Scheduling — Appointment events trigger onboarding, AWV
prep, and post-visit billing workflows.
- Clinical Documentation — Encounter sign-off triggers
billing, communication, and referral workflows; encounter data populates AVS,
progress notes, and discharge summaries.
- RCM — Claim submission and denial events trigger billing
and appeal workflows; superbills and statements reference RCM entities.
- Labs / Imaging — Result events trigger follow-up workflows
and populate results letters.
- Referrals — Referral orders trigger the referral workflow
chain; referral letters and clinical summaries are generated as documents.
- Task Management — Workflow steps of type CreateTask and
HumanGate insert tasks into the unified task queue.