used standard weightbearing terms
Restricted cases also frequently lacked rationale, quantification, or duration.
Read the 2025 audit ↗Orthopaedic discharge reconciliation
No rehab on conflicting orders.
LimbRelay compares the operative note, active order, therapy note, and discharge handoff. It cites the exact mismatch, routes one clarification, and rechecks the packet before a mobility plan can be released.
It never chooses a restriction.Exact-source comparison, named-clinician resolution, human release.
Episode LR-204Mobility release gate
BlockedOROrderPTDC
Weightbearingcritical conflict
Signed operative note“Left lower limb is Non Weightbearing for six weeks…”
does not match
Draft discharge summary“Left lower limb is Unrestricted Weightbearing.”
Agent's next actionAsk the treating surgeon to clarify
Proposal only · no order changed · no message sent
The failure is in the handoff
The restriction exists. The agreement often doesn't.
A protocol library tells people what usually happens. LimbRelay checks what these specific, already-authored records actually say before the patient crosses a care boundary.
omitted safety restrictions or precautions
Discharge communication was compared with what receiving clinicians needed for mobility and self-care.
Read the transition study ↗omitted assistive devices
A receiving therapist should not have to reconstruct a walker, brace, or restriction from scattered notes.
View the BOAST standard ↗These studies establish a documentation problem, not product efficacy. The first honest test is whether LimbRelay finds material discrepancies faster than a human reviewer in 50 consecutive, de-identified packets.
Interactive agent loop
Reconcile the packet. Don't invent the answer.
Switch cases, inspect every quote, prepare a bounded clarification, then record a fictional signed response and watch the release gate rerun.
Ruleset2024-08BOAST terminology profile
✓ObserveSources received
✓Extract23 exact quotes
✓Reconcile8 fields checked
4ClarifyHuman action needed
5RecheckWaiting
6ReleaseBlocked
02–03 · Extract + reconcile
2 blockersMobility contract
Selected field
ConflictWeightbearing
Four source documents observed. Reconciliation is current.
Standalone before integration
Paste two de-identified records. Check them locally.
This bounded prototype recognizes the locked terminology and common restriction phrases in the browser. It proves the reconciliation behavior without pretending to be a production clinical model.
Browser memory only.No upload, persistence, EHR connection, or external action. Fictional or explicitly de-identified text only.
Local result
1 blockerDo not release this packet
2sources
11supported claims
1conflicts
0missing
Weightbearing conflicts across sources
2 different values are documented.
Rules-based prototype result · no diagnosis · no clinical recommendation · human review required
Where the AI belongs
Semantic extraction is a proposal, never the release gate.
- 01Model proposes
Schema-bounded field, value, source ID, and exact quote pairs from free-text records.
- 02Rules verify
The quote must exist, the field must be allowed, and agreement is computed deterministically.
- 03Human clarifies
A named clinician selects the authoritative instruction; the model cannot resolve it.
- 04Agent rechecks
New or expiring source state reopens the loop and versions the plan.
Value has a pass/fail test
Don't sell the dashboard. Prove the saved comparison.
The product earns a right to exist only if it finds material handoff problems with less work than opening and comparing the records manually.
A therapist or coordinator finds the latest note, order, PT entry, and discharge draft, then manually compares each field.
Exact quotes, field-level agreement, a named owner, and a clarification draft—without choosing the answer.
The signed clarification is rechecked, source-linked, and invalidated when a newer instruction arrives or review expires.
50consecutive packets
De-identified retrospective reference set.
≥95%material-conflict sensitivity
Against two-reviewer adjudication.
0false releases
No known material conflict may pass the gate.
<2mmedian human review
Otherwise the agent adds work instead of removing it.
Kill test
If an EHR template or shared orthopaedic/PT chart prevents the failure with comparable effort, stop building a standalone company.
PrismEHR, aurii, Axone, Lifemaan, transition-audit tools, generic clinical-data reconciliation, and EHR rules are credible substitutes. The defensible hypothesis is the exact quote-backed reconciliation → clarification → recheck loop, not “AI for weightbearing.”
Agreement and closure
- Source-linked mobility extraction
- Cross-document discrepancy detection
- Missing-field and terminology checks
- Named clarification ownership
- Recheck, version, expiry, and audit
The actual restriction
- Weightbearing, brace, ROM, and duration
- Which source supersedes another
- Whether a plan is clinically appropriate
- Any order or patient-facing instruction
- Final human release