Overview
Bill-wise Critical Callout — redesign for order-level handling, centralized operations worklist, and unified callout tracking.
Bill-wise Critical Callout
Critical Callout is the workflow that ensures lab staff or doctors communicate out of normal range, life-threatening test results to the responsible party — a referral doctor, the patient's organisation, or the patient — before or immediately after reports are finalised.
This document redesigns callout from report-wise to order-wise so that all critical reports in a single order can be acted on together.
Related JIRA
Whimsical
Why is Critical Callout needed?
Some test results fall outside safe clinical thresholds. When this happens, simply delivering a report is not enough — the result must be actively communicated to someone who can act on it immediately.
Labs are operationally and legally expected to:
- Identify which results are beyond normal and beyond critical bounds
- Communicate those results to the right person (referral doctor, organisation, or patient)
- Maintain a traceable record of that communication
Before this redesign, callout was handled one report at a time, which meant:
- A patient with three critical reports in one order required three separate callout actions
- There was no centralised queue for operations teams to manage pending callouts
- Incomplete communication attempts had no tracked state — they simply vanished
- History was not visible alongside the action, forcing users to navigate away for context
How critical status is determined
A parameter is considered critical when its value falls outside both the normal range and the critical range configured in the report format.
| Parameter | Normal Range | Critical Range | Patient Value | Result |
|---|---|---|---|---|
| WBC Count | 4,000 – 11,000 | 2,000 – 25,000 | 1,500 | Critical Low |
| WBC Count | 4,000 – 11,000 | 2,000 – 25,000 | 30,000 | Critical High |
| WBC Count | 4,000 – 11,000 | 2,000 – 25,000 | 7,500 | Normal |
For list-field (qualitative) parameters, criticality is determined by a flag (is_critical = 2) in the parameter's defaultDescription mapping rather than a numeric range.
Who can perform a Critical Callout?
| Role | Where |
|---|---|
| Lab staff (lab login) | Report Entry footer, Waiting List, Operations Worklist |
| Doctors (doctor login) | Doctor Waiting List, Patient-wise Report List, Report Entry footer |
Both roles have access to the same modal and the same action set (Save Draft / Notify and Mark as Done). Department-scope filtering is applied on the backend so each user only sees reports relevant to their assigned department.
Is Critical Callout mandatory?
By default, it is not mandatory. It is an action that becomes available once a report has critical values.
However, it can be made mandatory by enabling "Always send notification when critical values are identified" in the Notify Configuration tab. When this setting is on:
- The callout step is enforced when signing reports with critical values
- Exemptions apply automatically for: auto-approval, auto-dispatch, Sign All, and mobile app flows
See Notify Configuration for full settings reference.
Data model — which fields hold the status
Two database entities track callout state:
LabReportRelation.criticalValues— an integer field on every report row that tracks the current callout status:CriticalCallouttable — a separate audit table that stores one record per callout action. For draft callouts,lab_reportisnulland onlybillis set, meaning one draft record represents the whole order. For completed callouts, one record is created per report.
Where can a callout be triggered?
All surfaces open the same CriticalNotificationModal. See Worklist Guide for a step-by-step walkthrough of the modal and the callout actions.
Feature scope summary
- Callout is now order-wise — one action covers all critical reports in the order
- Callout Attempted is a first-class draft status, not just a missed action
- A new Critical Callout Worklist under Operations provides a centralised queue
- Callout history is visible inside the same modal — no navigation required
- All communication channels (Email, Fax, SMS, WhatsApp) are selectable per callout action
- Notification configuration is unchanged for labs that have it already set up