AI interpretation
How rule-based flags and AI (LLM) interpretation work, and which plan unlocks each
Two layers of interpretation, in two different places.
Rule-based flags — on the gateway, every ECG, every plan
Deterministic flags run on the gateway at ingest time, before the record is queued for cloud sync. Every ECG gets them; no plan check, no internet round-trip, no extra cost. Computes:
- Heart rate band (bradycardia < 60, tachycardia > 100)
- PR interval (1° AV block > 200 ms)
- QT / QTc (long QT > 460 ms)
- ST elevation / depression (lead-by-lead threshold)
- Axis deviation (left / right / extreme)
Each flag carries a severity (info / borderline / alert). Flags are written into the HL7 OBX segments delivered to your HMIS, into the FHIR Observation.interpretation field, and onto the ECG record stored locally on the gateway.
Interpretation runs entirely on the gateway, using AI models distributed from the X:Connect Control Panel. The Control Panel never receives or stores the record itself — only licence checks and anonymous usage counters cross the wire.
AI = LLM augmentation — in the cloud, plan-gated
When this doc and the UI say "AI", we mean the LLM. It's the only AI surface in the product. Triggered when:
- A clinician clicks Run AI analysis on the ECG detail page, or
AI_AUTO_RUN=truein the cloud-managed gateway config (auto-runs on every record).
The LLM receives the rule flags, measurements, and a 12-lead waveform summary, and returns a one-paragraph clinical narrative in plain English. Latency: 3–8 s.
Plan availability
| Plan | Rule flags (gateway) | AI / LLM (cloud) |
|---|---|---|
| Basic | ✓ | — |
| Professional | ✓ | ✓ |
| Enterprise | ✓ | ✓ |
| Multi-site | ✓ | ✓ |
Rule flags are baked into the gateway, so every tenant gets them regardless of plan. AI / LLM access is gated by the ai_interpretation flag on the plan — Basic doesn't include it, every paid plan does.
What the AI is NOT
- Not a diagnosis. Output is labelled "AI assist — clinician review required" in the UI and HL7.
- Not a regulatory device. We do not claim FDA/CE clearance for the LLM output.
- Not a replacement for the rule flags — they always run too.
Cost
LLM calls are metered: each tenant's monthly call count is visible at /admin/billing/usage (OFFIN) and /usage (facility admin). Plans include a generous monthly bundle; overage is billed per 1 000 calls.
Disabling
Set AI_AUTO_RUN=false in cloud-managed gateway config to turn off auto-runs. The manual Run AI analysis button is hidden on Basic.
Roadmap
Cohort rules — comparing a record to the same patient's prior ECGs, or to a site-trained baseline — are on the roadmap. They'd run on the gateway / VitaLink hub (where the records live), distributed as models from the Control Panel — never by sending records to the cloud.