# Automated Notifications

## Overview

Automations in Welkin can trigger in-app notifications to care team members, providing more sophisticated control over when and to whom notifications are sent compared to standard system notifications. Using automations to send notifications allows you to alert care team members to critical patient events, milestone completions, or conditions requiring intervention.

This guide explains how to create automations that deliver notifications with custom messaging to specific team members or roles.

## Differences: Automations vs. System Notifications

### System Notifications

System notifications are built-in Welkin alerts for standard events:

* Assessment completed
* Patient message received
* Appointment scheduled
* Patient enrolled in program

**Limitations:**

* Limited customization
* Can't add specific clinical context
* Apply to all users in a role

### Automated Notifications

Automations give you advanced control:

* **Custom triggers** – Fire on any event in your system
* **Detailed conditions** – Only alert when specific conditions are met
* **Personalized messages** – Include clinical data and context
* **Selective recipients** – Alert specific users or roles
* **Complex workflows** – Combine with other actions (send message, create task, update data)

## How to Create an Automated Notification

### Step 1: Create an Automation

1. Log into Designer
2. Click **Create Draft** to start a new configuration draft
3. Navigate to **Automations** in the left sidebar
4. Click **+ New** to create a new automation

For detailed automation creation steps, see [Designer: How to Create Automations](/designer/automations/designer-how-to-create-automations.md).

### Step 2: Define the Trigger Event

Choose what event initiates the notification:

**Common Trigger Types:**

1. **Assessment Completed** – When a patient finishes an assessment
   * Example: "Send notification when Depression Screening is completed"
2. **Data Type Updated** – When a specific CDT field is updated
   * Example: "Send notification when blood pressure is entered and it's > 140 systolic"
3. **Program Change** – When patient enrolled/dis-enrolled from program
   * Example: "Send notification when patient enrolled in Intensive Intervention program"
4. **Date Milestone** – At a specific time interval
   * Example: "Send notification 30 days after assessment was last completed"
5. **Encounter Completed** – When care team completes an encounter
   * Example: "Send notification when Initial Assessment encounter is finished"
6. **Task-Related** – When task is created, completed, or overdue
   * Example: "Send notification when task assigned to this user is overdue"

### Step 3: Add Conditions

Add conditions to ensure the notification only sends when truly needed:

**Condition Examples:**

* **Program/Phase Status** – "Patient is enrolled in Behavioral Health > Intake phase"
* **Field Value Thresholds** – "Blood pressure systolic > 140"
* **Assessment Score Range** – "Depression score > 15 (moderate-to-severe)"
* **Time-Based** – "30 days have passed since last assessment"
* **Field Comparison** – "Current value is higher than previous value by > 5%"
* **Multiple Conditions (AND)** – "Patient in program AND score > threshold AND not already notified in past 7 days"

Complex conditions prevent alert fatigue by only notifying when truly relevant.

### Step 4: Select "Notification" as the Action

1. In the automation editor, find the **Actions** section
2. Click **+ Add Action** or select from action dropdown
3. Choose **Notification** as the action type
4. You'll see three fields to configure:

## Configuring the Notification

### Field 1: Body

The message content displayed to the care team member:

**Good Notification Examples:**

```
Patient's blood pressure is elevated (SBP: 155 mmHg).
Follow-up call recommended.
```

```
Moderate-to-severe depression symptoms detected (PHQ-9: 18).
Patient may need psychiatric referral.
Consider scheduling urgent appointment.
```

```
Patient completed initial intake assessment.
Ready to enroll in treatment program.
Create care plan before next scheduled appointment.
```

**Tips for Effective Notification Text:**

1. **Be Specific** – Include relevant data values
   * ✓ "BP 155/95" vs. ✗ "BP is high"
2. **Suggest Action** – Tell care team what to do
   * ✓ "Consider psychiatry referral" vs. ✗ "Something might be needed"
3. **Include Context** – Why is this notification important?
   * ✓ "Score indicates moderate depression requiring treatment escalation"
4. **Keep Concise** – Notification should be readable at a glance
   * ✓ 1-2 sentences vs. ✗ Long paragraphs
5. **Use Variables** – Include patient/clinical data
   * `{{patient_name}}` – Patient full name
   * `{{patient_mrn}}` – Medical record number
   * `{{field_value}}` – The triggering value
   * `{{current_date}}` – Today's date
   * `{{assessment_score}}` – Assessment result

**Example with Variables:**

```
Patient {{patient_name}} (MRN: {{patient_mrn}})
completed {{assessment_title}} with score {{assessment_score}}.
This indicates {{interpretation}}.
Review within 24 hours.
```

### Field 2: Care Team Member(s)

Specify who receives the notification:

#### Option A: Specific Care Team Members

1. Click the **Care Team Member** dropdown
2. Search for and select specific team members by name
3. Can select multiple members:
   * Primary care provider
   * Care coordinator
   * Behavioral health specialist
4. All selected members receive the notification

**When to use:**

* Notifications requiring specific expertise
* Patient-specific follow-up assigned to certain provider
* Escalations to supervisor

#### Option B: By Role

1. Leave **Care Team Member** section empty
2. Go to **Role(s)** field
3. Select one or more roles:
   * Care Manager
   * Nurse
   * Psychiatrist
   * Supervisor
   * Any custom roles configured in your system
4. All users with the selected role(s) receive the notification

**When to use:**

* Alert all members of a role to a condition
* When specific user assignment is unknown
* Shared responsibility situations

**Example Role Selections:**

* "Alert all Behavioral Health providers"
* "Alert supervisor and assigned care manager"
* "Alert all Nurses and Care Managers"

### Field 3: Role(s)

As noted above, select specific roles if not selecting individual users.

## Notification Behavior

### How Notifications Appear

Once published, when the automation triggers:

1. **In-App Notification** – Care team members see notification icon/badge in Care app
2. **Notification Center** – Notification appears in their notification list
3. **Timestamp** – Notification shows when it was triggered
4. **Actionable** – Often links to the patient or assessment triggering it
5. **Persistent** – Stays until user marks as read/resolved

### Notification Delivery Timing

* **Real-time** – Most notifications deliver within seconds
* **Delayed Notifications** – Some automations can delay (e.g., "Notify 2 hours after assessment is completed")
* **Batch Notifications** – System may batch multiple notifications in some cases

## Practical Examples

### Example 1: High Blood Pressure Alert

**Trigger:** Data Type Updated (blood pressure)

**Conditions:**

* Systolic pressure > 160 mmHg
* Patient in Hypertension program

**Action - Notification:**

```
Body: "Patient {{patient_name}} has elevated BP ({{systolic}}/{{diastolic}} mmHg).
Consider urgent follow-up or hospital referral."

Recipients: Role = "Nurse" OR Role = "Supervising Provider"
```

**Result:** Nurses and supervisors immediately notified of critical BP reading.

### Example 2: Depression Screening Follow-up

**Trigger:** Assessment Completed (PHQ-9)

**Conditions:**

* PHQ-9 score between 15-20 (moderate-to-severe)
* No notification sent in past 30 days

**Action - Notification:**

```
Body: "{{patient_name}} completed PHQ-9 screening (Score: {{score}}/27).
Moderate-to-severe symptoms detected.
Consider psychiatric referral or therapy intensification."

Recipients: Specific person = {{assigned_care_manager}}
```

**Result:** Patient's assigned care manager receives alert for personalized follow-up.

### Example 3: Treatment Non-Response

**Trigger:** Data Type Updated (assessment score)

**Conditions:**

* In program > 8 weeks
* Current score > baseline score (worsening)
* User has not been notified in 30 days

**Action - Notification:**

```
Body: "{{patient_name}} shows worsening symptoms.
Previous score: {{previous_score}}, Current: {{current_score}}.
Care plan adjustment may be needed.
Schedule review appointment."

Recipients: Role = "Care Manager"
```

**Result:** Care managers alerted to treatment non-response for prompt intervention.

### Example 4: Overdue Assessment

**Trigger:** Date Milestone (30+ days since last assessment)

**Conditions:**

* Patient is in active program
* Expected to complete quarterly assessment

**Action - Notification:**

```
Body: "{{patient_name}} is overdue for {{assessment_name}}.
Last completed {{days_ago}} days ago.
Consider sending reminder or scheduling completion."

Recipients: Role = "Care Manager"
```

**Result:** Care managers reminded to request assessment completion.

## Best Practices

1. **Be Selective** – Only trigger notifications for truly important events
   * Too many notifications cause alert fatigue
   * Care team may ignore or disable notifications
2. **Be Specific** – Include data that helps care team understand the alert
   * Not: "Patient assessment completed"
   * Yes: "PHQ-9 completed with score 22 (severe depression)"
3. **Suggest Action** – Tell recipients what to do next
   * Makes it clear whether action is needed
   * Reduces time to decision
4. **Include Timeline** – Indicate urgency
   * "Review within 24 hours" vs. "Review when convenient"
5. **Target Appropriately** – Send to people who can act
   * Don't alert entire team if only one person can help
   * Use role-based alerts when ownership is shared
6. **Avoid Duplicates** – Don't create multiple automations for same event
   * Consolidate similar triggers
   * Can use multiple notification actions in one automation
7. **Test Notifications** – Before publishing
   * Create test patient in automation conditions
   * Verify notification appears correctly
   * Verify it goes to right people
8. **Monitor** – Review notification effectiveness
   * Do care team act on notifications?
   * Are there too many/too few?
   * Adjust conditions based on team feedback
9. **Document** – Keep notes on what each automation notification does
   * Why was it created?
   * What conditions trigger it?
   * What action is expected?
10. **Regular Review** – Periodically audit automations
    * Remove ones no longer needed
    * Update for changing workflows
    * Consolidate redundant alerts

## Combining Notifications with Other Actions

A single automation can perform multiple actions:

**Example Multi-Action Automation:**

```
Trigger: Assessment score indicates suicide risk

Conditions:
- Assessment = "Suicide Risk Screening"
- Score > 8 (elevated risk)

Actions:
1. Send Notification to: "Care Manager" + "Psychiatrist"
   Message: "Elevated suicide risk detected. Immediate intervention needed."

2. Create Task for: "Care Manager"
   Task: "Schedule urgent psychiatric evaluation for {{patient_name}}"

3. Send Message to: Patient
   Message: "We're concerned about your safety. Please contact the crisis line: 1-800-XXX-XXXX"

4. Update Patient Field: "risk_flag" = "URGENT"
```

This creates a coordinated response: notification to clinical team, task assignment, patient contact, and data update.

## Related Topics

* [Designer: How to Create Automations](/designer/automations/designer-how-to-create-automations.md) – Basic automation creation
* [Create Advanced Automations](/designer/automations/create-advanced-automations.md) – Complex automation patterns
* [Automations that Trigger Outbound Communications](/designer/automations/automations-that-trigger-outbound-communications.md) – Message/SMS automations
* [Create User Notifications](/designer/notifications-and-communications/create-user-notifications.md) – Alternative notification method
* [Custom Data Types (CDT): Designer](/designer/custom-data-types/custom-data-types-cdt-designer.md) – Data triggering automations


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