Sentinel
Sentinel — the missing order agent for clinical conversations After every visit, spoken plans leak out of the EHR: doses that never got updated, referrals that bounce, follow-ups nobody booked.
Core trick
Extracts verbal commitments with verified transcript quotes, diffs them against FHIR, and has an adversarial second pass challenge each finding.
Description
Sentinel — the missing order agent for clinical conversations
After every visit, spoken plans leak out of the EHR: doses that never got updated, referrals that bounce, follow-ups nobody booked. Sentinel audits the record against the conversation itself — and fixes it.
Built today on Claude: the agent extracts every verbal commitment with word-for-word verified quotes, reconciles them against FHIR, and classifies discrepancies as WRONG, INCOMPLETE, or MISSING. An adversarial auditor agent challenges every finding before a clinician sees it. Repairs are FHIR-shaped, clinician-approved, editable, undoable, and fully audit-logged.
Abridge captures the plan. Sentinel makes sure the plan happens.
README excerpt
# Abridge Missing Order Sentinel > The visit is not complete when the note is signed. It is complete when every agreed action is represented correctly in the EHR. Sentinel reconciles commitments made in an ambient clinical conversation against the final FHIR record. It links every finding to an exact transcript quote, classifies discrepancies, proposes FHIR-shaped repairs, requires clinician approval, and records an auditable before/after trail. Before a finding reaches the clinician, a second adversarial Claude pass attempts to reject it. Confirmed findings retain a clinician-readable safety rationale, downgraded findings carry a lower risk, and rejected findings remain inspectable in a collapsed suppression queue. The audit is batched once per encounter, cached with the analysis fingerprint, and fails open so an unavailable reviewer cannot block the demo. Neither analysis pass receives the evaluation manifest. Repair review uses editable, clinician-facing fields rather than raw FHIR. Approved and rejected decisions move into a Completed view, where Undo restores the exact prior runtime resource and records the reversal without deleting audit history. Generic encounters expose suggestions as editable follow-up actions; accepting one records review without pretending that an EHR write-back occurred. ## Demo case The clinician and Julius Renner agree on eight actions. The synthetic post-visit EHR contains: - a planted lisinopril dose discrepancy: 40 mg instead of 10 mg;