A structured triage process
Isolate the failing layer in order and confirm exactly where the message stops. Working top to bottom keeps you from guessing.
| Layer | What to check | If it fails here |
|---|---|---|
| 1. Source system | Was the event or message generated? | Issue is upstream in the EHR or source |
| 2. Outbound message | Did the source send it? Check the outbound queue | Source-side send or config issue |
| 3. Interface engine | Did the engine receive and process it? | Engine connectivity or routing issue |
| 4. Mapping | Did the fields map correctly? | Mapping or dictionary gap |
| 5. Inbound processing | Did the destination accept it? | Destination intake or validation rejection |
| 6. Destination system | Did the record land correctly? | Destination-side config or data issue |
Common failure patterns
- Dropped or stuck messages from queue backups, connectivity, or engine errors.
- Patient identity mismatches and duplicates from MRN handling or merges.
- Missing or duplicate charges.
- Scheduling and appointment sync errors.
- Orders not crossing, or crossing incorrectly.
- Results or documentation not posting back to the EHR.
- Silent failures with no alerting.
Validate after a fix
- Reprocess the corrected message and confirm it lands correctly.
- Confirm the downstream charge or result is right.
- Make sure the fix did not create duplicates.
- Confirm monitoring and alerting exists for that route.
- Document the root cause.
Preventing repeat failures
- Monitor message flow and error queues.
- Alert on silent routes.
- Assign clear ownership for triage.
- Keep mapping and known-issue documentation current.
Common questions
- Can you help during an active outage?
- We can help you work the triage process and stabilize the interface. Response depends on current availability and your access setup. Reach out with your situation and timeline.
GlobalSABT is an independent consulting company and is not affiliated with, certified by, or endorsed by Epic, Varian, Elekta, Oracle Cerner, or any other system vendor. Product names describe environments only. Do not submit Protected Health Information, patient identifiers, medical record numbers, or confidential clinical data through this form.