Running Guideline Evaluations
A guideline evaluation runs a set of clinical rules against a population of patients in your business unit. You can run evaluations in Report mode to analyze results without creating tasks, or in Active mode to trigger real prior-authorization workflows.
Triggering an Evaluation
You can trigger an evaluation from the guideline’s detail page or from a patient’s chart (wherever the Run Guideline button appears).
- Open the guideline you want to evaluate.
- Click Run Guideline. A dialog opens.
Evaluation Mode
Select one of:
- Active — the evaluation runs live. Patients who meet the criteria generate prior-authorization tasks, and contact with prescribers, patients, and pharmacies occurs according to the guideline’s contact settings.
- Report — the evaluation runs in analysis mode only. No tasks are created and no contacts are sent. Use this to preview which patients would be affected before committing to an Active run.
Evaluation Type
Select one of:
- Auto — the system detects from each patient’s claim evidence whether initiation or continuation rules apply. Use this for population-wide runs.
- Initiation — evaluates only the initiation rules. Suitable for patients who are starting therapy.
- Continuation — evaluates only the continuation rules. Suitable for patients who are already on the medication and approaching a renewal.
Contact Settings (Active mode only)
When you select Active mode, additional dropdowns appear for Prescriber Contact, Patient Contact, and other contact options. These override the guideline’s default contact settings for this run only.
Also evaluate other indications
If the guideline targets a drug with multiple indications, you can check Also evaluate other indications for the same drug to include all related guidelines in a single multi-guideline evaluation.
Click Run to start the evaluation.
Viewing Batch Evaluations
All evaluations — past and in progress — are visible at Settings → Guideline Evaluations.
The table shows:
| Column | What it tells you |
|---|---|
| Status | Pending / Running / Completed / Failed |
| Guideline | The guideline that was evaluated (links to the guideline detail) |
| Mode | Report or Live |
| Created | When the evaluation was triggered |
| Completed | When it finished |
Click any row to open the evaluation’s detail page.
Monitoring Evaluation Progress
A running evaluation shows a progress bar in the Status column. The bar fills as the system processes patients. For large populations this may take several minutes.
Refresh the page or wait — the table updates automatically when the evaluation completes.
Reviewing Patient Results
Open a completed evaluation to see the full results. The Patient Results table lists every patient that was evaluated and shows:
- The patient’s name (links to their chart)
- The determination (Approved / Denied / Data Request / etc.)
- The guideline rule outcome
- Any tasks that were created (in Active mode)
Click a patient row to jump to their chart and view the related prior-authorization task in context.