Worked sample, fictionalized
Sample Workflow Reconstruction
This example shows how Pulse can organize a historical workflow around the approved standard, authority, events, human intervention, exception path, outcome, and evidence limitations.
Reconstruction map
Follow the evidence path across systems and parties.
The goal is not to create a perfect narrative from assumptions. It is to show what the records support and where the path cannot be reproduced.
Evidence inventory
State what is present, missing, and only partially supported.
A defensible reconstruction makes the limitations visible rather than filling them silently.
| Element | Expected record | Worked-sample observation |
|---|---|---|
| Approved standard | Plan criteria version PA-2026.04, effective April 1, 2026 | Available in document repository |
| Authority | Vendor clinical reviewer and plan-design escalation role | Reviewer role present; delegation reference incomplete |
| Required inputs | Eligibility, diagnosis, prior treatment, requested drug, supporting notes | All present except one timestamped source reference |
| Workflow event | Automated routing to clinical review | Event timestamp present; rules version not bound to event |
| Human intervention | Reviewer requested additional information | Action present; rationale preserved in free text |
| Exception path | Escalation after missing-information timeout | Escalation occurred; authority token not preserved |
| Final action | Request denied and notice issued | Outcome and notice available |
| Replayability | Reproduce criteria, authority, and conditions at decision time | Partially supported |
Illustrative finding
The action can be identified, but the decision-time authority and criteria version cannot be fully replayed.
The available records support that a denial and notice occurred. They do not fully bind the rules version and escalation authority to the decision event.
- Condition: rules version and authority token not preserved with the event
- Criterion: the approved criteria package requires both
- Consequence: the organization cannot fully reproduce why the action was authorized
- Recommendation: bind version, delegation reference, and escalation result to the Decision Artifact
This is a fictional worked sample. It does not describe a real employer, broker, PBM, carrier, vendor, member, or completed engagement.
Bring one real workflow and the records available today.
The first diagnostic can be narrow, offline, and bounded to one historical action.