Signet · Hold
Held reports wait for a person.
Four rules decide what may never go out unattended. Fail-closed: nothing reaches a patient before a clinician releases it. An unbound source fails closed into a hold — never a sample.
- Gate Fail-closed Nothing reaches a patient before a clinician releases it.
- Cases Four cases Incomplete, invalid, mismatched, or critical — every time.
- Critical Never automatic A critical value never takes the unattended path.
A protocol acknowledgement is not a release. Intake may issue a signed receipt that the record arrived. That receipt confirms custody. It does not authorise delivery, compose a report, or clear a hold.
Cases
Incomplete, invalid, mismatched, or critical
Automation is only trustworthy where it knows when to stop.
- Incomplete panelA test the package promised is missing from the result set.
- Invalid unit or rangeThe laboratory's unit or reference range does not match the marker's definition. (Distinct from Intake's missing or unusable source range — never derived.)
- Mismatched test codeA local code cannot be mapped to a known marker with confidence.
- Critical valueA result inside the clinic's critical band. Flagged by the lab; decided by the clinician.
Held cases stay visible in the clock. They are not hidden and they are not auto-released.
Sign-off
A person still sends.
Reports that trip any case wait on the clinician sign-off ladder. Bulk release is safe to repeat: the same release does not create a second report.
Only a report that has passed every hold rule may take the automatic path. A critical value never takes it. Protocol acknowledgement records an action; it does not release the report.
AI-assisted interpretation, smart reports and referral prediction sit in Compose. They reach a patient only after a named clinician releases. Critical never auto.
Signet is not a medical device / SaMD / FDA / CE, and is not clinically validated or clinically approved.
Refusals
What Hold refuses
- Unattended release of incomplete, invalid, mismatched or critical work
- An automatic path from critical flag to patient delivery
- Bulk release that would skip a failed hold rule — bulk release, where enabled for the clinic, remains subject to every hold gate
Lineage
What you can prove later
Each hold has a reason. Each release is receipted. A later review can show why something waited and who released it.
Clinician sign-off sits on a ladder the clinic controls.
Delivery partners: write to the partner team.