AlertDx - Clinical Backstop for Diagnostic Errors

The Diagnostic Error Problem

7.4M

Annual ED misdiagnoses in the US

2.6M

Result in patient harm

1 in 350

ED patients suffer permanent disability or death from diagnostic error

Cognitive Biases Behind These Errors

Cognitive errors do not equate to lack of knowledge or care but reflect how human thinking works under the hectic pace of emergency departments:

Premature closure—accepting a diagnosis before fully verifying it
Anchoring—locking onto an initial diagnosis despite contradictory evidence
System 1 thinking—over-reliance on fast, intuitive pattern recognition under time pressure
Confirmation bias—favoring information that supports the working diagnosis
Availability heuristic—overweighting diagnoses that come easily to mind
Base rate neglect—ignoring disease prevalence when estimating probability
Framing effects—being influenced by how information is presented by triage or prior workups
Context factors—fatigue, interruptions, cognitive load, shift changes, and production pressure

The National Academy of Medicine has called diagnostic error a “blind spot” for modern medicine and improving diagnosis a “moral, professional, and public health imperative.”

How AlertDx Works

Continuous surveillance with on-demand AI-assisted documentation

Continuous Surveillance & Accrual

AlertDx maintains a background data engine that periodically accrues new clinical data—labs, vitals, imaging, clinical notes—via FHIR delta queries. The system constantly updates its differential diagnosis for each patient.

FHIR R4 Integration
Background Polling
Stateful Analysis
Delta Queries

Real-Time Safety Net

When a clinician opens a patient record, AlertDx provides an immediate safety check via a CDS Hook. If the analysis indicates a possible missed dangerous diagnosis, a high-priority Red alert card appears with a link to the full analysis. Blue and Orange analyses remain silent to prevent alert fatigue, but are available upon demand.

Red — Missed Diagnosis Orange — Lower Risk Blue — No Concerns

On-Demand MDM & Documentation

Clinicians can launch AlertDx at any time via a button in the EMR. The SMART on FHIR tool provides AI-assisted differential diagnosis, a medical decision-making documentation tool, and a findings addendum builder. Frontier generative AI analyzes the full clinical context—not just rules or thresholds.

Post-Documentation Safety Net

After the encounter note is finalized, AlertDx runs a final analysis. If a Red event is detected post-finalization, an alert is delivered to the clinician’s inbox, closing the loop even after the clinician has left the chart.

Additional Features

Findings Addendum

Quick documentation of pertinent positives and negatives:

Mark findings as present or absent directly from the alert
System builds an addendum note for copying to the EMR record

Medical Decision Making Documentation Tool

AI-assisted differential diagnosis workspace:

Facilitates consideration of conditions and creates an MDM note describing the cognitive process
Supports documentation for appropriate billing and reimbursement

Automated Periodic Re-analysis

Background polling with configurable intervals via FHIR delta queries
Re-evaluation as new labs, vitals, and imaging become available

Alert Classification

Three-tier alert system to prevent alert fatigue:

Red—possible missed dangerous diagnosis (generates automated alert)
Orange—addressed or lower risk (available on demand)
Blue—no dangerous diagnoses identified (available on demand)

Director Management Dashboard

Administrative console for AlertDx deployment:

Site-based access control with role-based permissions (user, site admin, super admin)
Policy management for configurable diagnostic rules
Alert review with filtering, patient data viewing, and research feedback
Policy violation alert tracking

Site Configuration

Customizable for your institution:

Site-specific AI prompting
Configurable reasoning levels
Cost tracking per analysis

AlertDx: A Clinical Backstop