Ohtariv0.0.4
OS

Ortho1 Surgical Group

Orthopedic Surgery

  • Teams
    • CL

    Clinical

      Tickets
      Journeys
      Workflows
      Skills
      Knowledge Base
      Campaigns
      Assets
      Tools
      Settings
    BL

    Billing

    FO

    Front Office

KD

Kristopher Downing

Owner-Partner
Unpublished changes
Chat
Manual
O

Ohtari

Workflow builder

K
I want a workflow that fires when a post-op round flags something concerning. It should coordinate across the three teams — Clinical orders the wound culture and notifies the surgeon, Billing prepares the complication code and flags bundled-payment risk, and Charting writes the addendum to the op report. Care coordinator approves the whole bundle before any of it goes live.
+ Add risk-adjustment chart query
⚙ Adjust severity thresholds
+ Loop in social work for discharge delays
+ Add quarterly complication trend report
Trigger

Room Rounds flags a complication

Type:

Workflow event (Room Rounds)

Access:

System — fired by upstream Room Rounds escalation

Approval required
default

Approved by: Care coordinator · Surgeon on case

Human sign-off required before any patient, chart, claim, or financial action runs.

Athena · Read

Load case context for cross-team coordination

Reading from chart (8 fields)

episode.surgery.cpt
episode.surgery.date
episode.surgery.surgeon
episode.payer
episode.cjr_eligible
episode.bundled_payment_window
episode.op_report_id
episode.claim_status
Cache: 1 min
Latency: ~940ms
+ Bundled payment status
+ Days remaining in CJR window
Conditional

Triage severity — drives notification fan-out

Expression

severity = moderate → fan out to Clinical + Billing + Charting
TRUE

→ Run all three team lanes (next 3 steps)

FALSE

→ Mild path: chart-only addendum, skip team fan-out

Clinical lane
Clinical lane

Clinical: order wound culture + queue surgeon page

Clinical lane
Requires approval

Actions (4)

Order wound culture (CPT 87070)

Order DVT recheck protocol

Draft page to surgeon's nurse

Update DVT prophylaxis flag on episode

Writes

Order set
Episode flag: complication
Care plan update

Integrations

Athena · Order Entry
Twilio · Page
Billing lane
Billing lane

Billing: stub complication CPT + flag CJR bundle

Billing lane
Requires approval

Actions (4)

Stub complication CPT 998xx (held, not submitted)

Flag CJR bundled-payment risk on episode

Recalculate target margin given complication exposure

Queue biller ticket — review before claim submit

Writes

Claim staging table
CJR risk score
Biller ticket: OH-XXXX

Integrations

Availity (staging)
Athena · Billing
Charting lane
Charting lane

Charting: write addendum to operative report

Charting lane
Requires approval

Actions (4)

Draft addendum: complication noted on POD 1 with details

Add complication tag to episode timeline

Cross-reference order set + culture results placeholder

Queue surgeon signature on addendum

Writes

Op report v2 (draft)
Episode timeline event
Tag: complication

Integrations

Athena · Documents
Athena · Episode
Escalate

Route the full cross-team bundle to care coordinator

Route to:

Care coordinator

SLA:

1 hour ack

Requires human approval before sending

Channels

Needs Review
Page
SMS

Context attached

All 3 team drafts
Severity assessment
CJR financial exposure
Suggested timing
Athena · Write

On approval: commit all 3 lanes atomically

Field mapping (7)

clinical.orders

episode.orders

clinical.surgeon_page

episode.notifications

billing.complication_cpt

claim.staging

billing.cjr_risk

episode.bundled_risk

charting.addendum_draft

episode.documents

charting.complication_tag

episode.tags

approval.coordinator

audit_log.approvals

Idempotent
Event: Cross-team complication coordination

Applied Skills (1)

Post-op outcomes & escalation thresholds

Subspecialty-specific check-in questions and escalation thresholds for the post-op pathway.