Clinical decision support
AI-powered alerts that surface relevant patient history, flag potential drug interactions, and highlight abnormal trends — inside the visit, while you're working.
How it works
Clinical decision support (CDS) runs in the background when you open a SOAP visit. It reads the patient's full history — prior visits, medications, lab results, weight trends, and the current SOAP content as you type — and surfaces relevant alerts in a panel alongside the note.
Alerts are generated by AI but grounded in the patient's actual data. Each alert cites the specific values or history it's based on — you can see exactly where it came from, not just a generic warning.
CDS alerts are informational. Chartling never blocks a clinical action based on an alert — you may dismiss any alert and proceed. The decision is always yours.
Alert types
| Alert type | What triggers it | Example |
|---|---|---|
| Abnormal trend | A lab value or weight that has moved significantly from the patient's own baseline over multiple visits | BUN rising 40% over 6 months; patient losing >10% body weight in 90 days |
| Drug interaction | A medication added to the current plan that may interact with an existing active medication | Meloxicam added while patient is on enalapril; potential nephrotoxicity in renally-compromised patient |
| Breed / age risk | The patient's species, breed, or age puts them in a higher-risk group for a condition relevant to the current visit | Golden Retriever, 9 years old, presenting with exercise intolerance — cardiac screening note |
| Overdue preventive care | A vaccine, parasite prevention, or wellness exam is overdue based on the patient's species and age | Rabies vaccine expired 3 months ago; heartworm test last done 18 months ago |
| Contextual reminder | A prior visit note or open problem on the problem list is directly relevant to the current presenting complaint | Patient presented with polyuria 4 months ago — prior urinalysis was borderline; recheck recommended at time |
Where alerts appear
CDS alerts appear in the Insights panel — a collapsible sidebar on the right side of the SOAP note. The panel shows a count badge (e.g., "3 alerts") when there are active alerts. Click any alert to expand it and see the full detail and the source data.
Alerts also appear on the patient dashboard as a persistent summary, independent of any active visit. This lets you see a quick clinical overview before a visit even starts.
Acting on alerts
For each alert you can:
- Dismiss — hides the alert for this visit (it may reappear in future visits if the condition persists)
- Add to plan — appends a note or action to the SOAP Plan field based on the alert's recommendation
- Order lab — opens the lab order form pre-populated with the relevant test (e.g., urinalysis, renal panel)
- Copy to note — copies the alert summary into the SOAP Subjective or Assessment field as a clinical note
Drug interaction alerts that meet a severity threshold must be explicitly dismissed or actioned before the SOAP can be signed. You can still dismiss them — this is a prompt to confirm you've seen the alert, not a hard block.
How alerts are grounded
Every CDS alert is generated from the patient's actual records in Chartling — not from population statistics or generic rules. The AI reads the patient's visit history, lab results, current medications, weight logs, and the in-progress SOAP, and generates alerts specific to this patient's situation.
Clinical content — patient weight, lab values, active medications — is always passed to the AI model in kilograms and metric units, regardless of your clinic's display unit setting. Dosing and trend calculations stay consistent regardless of how values are shown on screen.
CDS is available on Intelligence and Practice tiers. It is not available on Operations-only plans.
FAQ
Yes. Go to Settings → Clinical → Decision support and toggle each alert category on or off. Changes apply for all vets in your clinic. Individual vets cannot override the clinic-level setting.
CDS currently covers canine and feline patients. Alerts for exotic species, birds, and pocket pets are on the roadmap but not yet available. For unsupported species, the Insights panel will show "No alerts available for this species."
Yes. Dismissed alerts are recorded in the audit trail (who dismissed them, when, and from which visit). If an alert was actioned (added to plan, lab ordered), that action is also logged. This gives a clear record of which clinical prompts were acknowledged.
CDS only knows about medications in Chartling. If a patient is on a medication from another clinic that isn't entered in their Chartling record, those interactions won't be detected. Staff should enter any known external medications in the patient's Meds tab so the system has complete information.