Routing Rules

Routing rules are the core of the Autorouter as the autorouter uses rules to automate how eReferrals are handled.

Rule Structure

Each rule has three components:

  1. Trigger: Event that starts the rule

    • Example: A new referral is received

  2. Action: What the system does in response

    • Example: Analyze and summarize referral data

  3. Enablement: Required tools/integrations for the rule to work

    • Example: AI enabled for document analysis

Each rule in the Autorouter listens for a specific event. You can create rules for one or more events and assign specific actions to them.

Creating Routing Rules

Once you have completed the steps to connect the Autorouter to your Ocean site, you can begin rules configuration. This video provides a walkthrough of how to create routing rules in the Autorouter.

AI-Driven Actions

Here are the types of automated actions the AI can take on your behalf, based on your rule configurations:

  1. eReferral Analysis: Analyze information in the eReferral, including the referring provider, patient information, referral form entries and the referrer.

    It is typically the first step in a rule, used to understand the context of the referral and guide what action(s) should be taken next — such as accepting, forwarding, or sending follow-up communications.

    Example: "If the patient is 18 or older, Decline the referral, Select 'Another provider is more appropriate.' from the list of decline reasons", If the patient is 19 years or older, do nothing

  2. Attachment Analysis: Analyze and summarize the information in the attachment files that are sent with an eReferral. This is typically a first step used to inform downstream actions based on content in the attachments.

  3. Triage and Assignment: Automatically assign a referral to the most appropriate provider based on information within the eReferral, or forward the referral to a specific directory listing (e.g., central intake, regional hub, or provider group).

  4. Request Management: Accept, decline, or complete a referral automatically when specific conditions are met (e.g., known pathways).

  5. Messaging: Send an Ocean message to the referrer (e.g., clarifications, request for information or instructions). Automatically send an email or SMS message to a specific recipient when conditions are met. Based on the contents of the eRequest, mark it as needing review with a message.

  6. Decision Support: Used before submission of a referral to warn or block based on form inputs, and/or provide context-sensitive guidance using Clinical Decision Support (CDS) integrations. e.g.: “This test may not be appropriate for the indicated condition.”

  7. eRequest Type Conversion: Convert an eReferral to an eConsult (or vice versa) when conditions suggest a virtual consult is more appropriate.

  8. Metadata Updates:

  • Change referral health service category
  • Add booking instructions
  • Add comments to the activity log
  • Add AI-generated comments or flag edge cases for manual review

Configuring Routing Rules in the Autorouter

For the autorouter to take action on an eRequest, permission must be granted to use certain Ocean tools and features. As such, the third part of rule creation involves tool enablement. An OceanMD staff member can assist with this.

Once you have completed the steps to connect the AutoRouter to your Ocean site, you can begin rules configuration.

  1. Select the +ADD RULE button
  2. Enter an intuitive name for your rule in Rule Name field
  3. Select the trigger event for the drop down
  4. In the instructions text box, write detailed instructions on what you want the rule to do once the trigger event has occurred.
  5. In the Enabled Tools Section, ensure that any tools that may be required to enact the rule you have created are toggled to “on”

Tips for Building Rules in the Interface

When entering instructions:

  • Be specific about keywords or criteria the AI should look for (e.g., referral reason, urgency, specialty).
  • Include clear logic paths (e.g., “if x, then do y”).
  • Add fallback steps (e.g., “if no match, mark for manual review”).
  • Use plain language, as the AI will interpret it with context

Testing Your Rules

Once routing rules are created, users can validate them in the Autorouter Testing tab by setting up sample data and simulating events to observe which rules are triggered.​

This helps ensure that rules behave as expected and edge cases are handled properly. This video provides a walkthrough of testing the autorouter rules.

Monitoring Activity

Rules Activity Logs

The Activity Log can be used to debug issues and validate automation performance. It shows:

  • Incoming messages from Ocean
  • Routing actions
  • Triggered rules
  • Success/failure of actions