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OvaFlow

Safety model

Keep separate facts separate.

Most coordination mistakes happen when one fact is mistaken for another: a read message for an accepted handoff, a published instruction for an understood one. OvaFlow is designed to keep each fact distinct.

Examples use fictional patient data

Nine facts

Separate facts, separate evidence

A read receipt is not an acknowledgment. A booked room is not a clearance. Each of these needs its own evidence before anyone relies on it.

  • Source received
  • Clinician signed
  • Published
  • Delivered
  • Read receipt
  • Acknowledged
  • Patient reported use
  • Coverage accepted
  • Clinically resolved
Each fact, the evidence it needs, and what it does not establish
FactEvidence neededDoes not establish
Source receivedAn identifiable source and the time it was receivedThat anyone reviewed it, or that it is valid
Clinician signedThe authorized signer, the revision and the signing eventThat follow-up work is done
PublishedA matching record in the destination system, for the right revisionDelivery, reading or acknowledgment
DeliveredThe channel's own delivery evidenceWho read it, or whether it was understood or used
Read receiptThe channel's own read evidenceAcknowledgment, understanding, reported use or accepted responsibility
AcknowledgedAn attributed acknowledgment of the current instructionCorrect performance or completed clinical review
Patient reported useThe original report, the reported time and the received timeA rewritten prescription or a verified administration
Coverage acceptedA named person, scope, time and acceptanceClosure of separately owned clinical work
Clinically resolvedAn authorized clinical resolution with current evidenceThat every administrative or lab task is complete

Design rules

Ten rules every part of OvaFlow is designed to keep

  1. Work is tied to one patient and episode, and a change of chart never silently moves a draft.
  2. A newer signed instruction retires older preparations; history is kept.
  3. A quiet inbox doesn't mean an expected result is absent; the last successful check stays visible.
  4. Offered work stays with its current owner until someone accepts it.
  5. A timeout after a possible send creates an unknown outcome, never a blind repeat.
  6. Signing, acknowledgment, patient reports, resource commitments and physical lab work are different events.
  7. Planned and actual times keep their own sources and time zones, and corrections never rewrite the original report.
  8. A model can't grant access, choose the patient, sign, transfer responsibility or act in an external system.
  9. Permissions apply to search, notifications, exports and model inputs, not only full records.
  10. A task closes only when its own evidence is in, and linked tasks stay open.

Uncertainty

Unknown is a valid answer

When OvaFlow can't establish the current patient, source or outcome, the affected action is held and the uncertainty is shown, rather than guessed.

  1. Publication outcome unknownA send or publish was attempted in the clinic's system, but the confirmation never came back before a timeout or network drop. The record may or may not have gone through.Next: Check the published record in the EMR
  2. One matching publication verifiedExactly one matching published record was observed in the clinic's own EMR or portal for the right patient, the right episode and the current signed revision.

How tasks pause and close

Where shortcuts fail, and how we hold

Clinical safety incidents rarely come from a single broken database; they happen when software conflates delivery with understanding or retries blindly after a timeout [1, 2, 3].

From lab arrival to resolution

Six steps to close an instruction, and three reasons to pause

State transitions
  1. 01
    Source receivedLab or note arrives
  2. 02
    Clinician signedMD signs version 3
  3. 03
    PublishedEMR readback confirmed
  4. 04
    AcknowledgedCurrent revision only
  5. 05
    Reported usePatient's actual time
  6. 06
    ResolvedAll evidence in
Pause at Step 02Superseded version retiredWhen version 3 (20:00 PDT) is signed, version 2 (20:30 PDT) stays in history and cannot be sent or confirmed.
Pause at Step 03Outcome unknown (no blind resend)If a connection drops on publish, OvaFlow holds automatic retries until the portal activity log is checked.
Pause at Step 04Read receipt is not acceptanceOpening a message or asking a syringe question never marks a dose taken or transfers an on-call handoff.
Common shortcuts vs. OvaFlow

What happens when software combines separate facts

01 · Read receipt mistaken for handoff acceptance

Common shortcut: Marking a task reassigned as soon as the on-call nurse opens the message thread.

OvaFlow rule: 'Coverage offered' at 20:26 PDT stays in Nora Ruiz's queue until Alex Kim explicitly clicks Accept at 20:28 PDT.

Prevents orphaned evening follow-ups during shift change [1].

02 · Network timeout followed by automatic retry

Common shortcut: Re-submitting a portal message when the browser spinner times out after 10 seconds.

OvaFlow rule: Enters 'Publication outcome unknown' and prompts an EMR readback check before any repeat send.

Prevents duplicate or out-of-order medication messages reaching the patient.

03 · Patient confirms an older instruction after a dose amendment

Common shortcut: Allowing 'Confirm' on any older text notification link in the patient's inbox.

OvaFlow rule: Version 3 (20:00 PDT) immediately retires Version 2 (20:30 PDT) as a superseded instruction; old links redirect to Version 3.

Prevents a patient from confirming an outdated 8:30 PM trigger time after the 8:00 PM amendment was signed.

04 · Empty lab inbox treated as 'all results normal'

Common shortcut: Showing only arrived lab results so a delayed outside draw looks like a quiet afternoon.

OvaFlow rule: Tracks every ordered draw or PGT biopsy as an 'Expected result' and shows the last verified check time.

Aligns with ONC SAFER Test Results Reporting guidance [3].

Common questions

Questions clinics ask about safety model

Why does OvaFlow treat 'Read receipt' and 'Acknowledged' as two separate states?

A push notification or portal message marked 'read' only proves a screen opened—sometimes on a shared tablet or while a patient is driving. For time-critical instructions like an evening trigger shot, OvaFlow requires an explicit attributed acknowledgment of the current revision and still tracks actual reported use separately.

What happens when a physician signs a second amendment 20 minutes after an earlier trigger instruction was prepared?

Rule 02 of the safety model immediately marks the earlier preparation as a superseded instruction. The older version remains visible in the audit trail for lineage, but its send and confirm buttons are locked so neither staff nor patient can act on stale timing.

How does OvaFlow handle a quiet inbox when a PGT report or morning lab draw hasn't arrived?

Instead of only displaying messages that have arrived, OvaFlow registers an 'Expected result' with a due window and shows the timestamp of the last verified check. If the feed is interrupted ('Observation interrupted'), the screen shows the interruption rather than an empty queue.

Why does a sensitive event (pregnancy loss or cycle cancellation) have its own safety rule?

Automated appointment nudges or congratulatory stage messages sent after a pregnancy loss or cancelled cycle cause severe distress. Recording a vital-status or sensitivity stop immediately halts routine reminders and routes follow-up to clinician-led care.

See it

Watch it hold in a walkthrough

Recordings of the interactive design prototype, with fictional patients and staff.

Safety model

Test the model on your hardest handoff.

Tell us the fact your team most often mistakes for another. We will show how it stays separate.