Setting sustained notifications for continuous readings

Sustained-reading settings evaluate a series of continuous readings to help reduce repeated notifications and notification fatigue. All Values checks whether every reading meets the threshold condition; Average compares their mean with the threshold. Sustainment uses a reading count, not a fixed duration, so timing depends on reading frequency and data availability. Settings should follow the patient’s monitoring plan.

Courtney Brundula
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Pulsewavedx

**Before you begin** Log in to [ca.pulsewavedx.com](http://ca.pulsewavedx.com) (Canada) or [pulsewavedx.com ](http://ca.pulsewavedx.com) (USA) using your username and password or Single Sign-On (SSO). Open the correct patient profile. Use the thresholds, sustained-reading count, comparison method, and notification recipients established by your clinical team.

Visit the Notification Tab

**Open the patient profile** and select **Notifications**. Confirm the patient identity before making changes.

Adding a Notification Trigger

Under Reading Threshold Triggers, select the **Readings tab if needed**. In the **Low and/or High** section, select **Add New Trigger**. The trigger configuration window opens.

Select the result type

Open Result Type and select the vital sign being monitored by the supported continuous device. Confirm the displayed unit before entering thresholds. For the temperature example, select Temperature (°C).

Enter the prescribed thresholds

Enter the **High Threshold and/or Low Threshold** required by the clinical team for this patient. Review the values and units carefully before continuing. The example below shows the High Threshold field; configure a low threshold only when required by the patient’s monitoring plan

**Timing example** In the **Radius T temperature example**, readings typically arrive approximately **once per minute**. At that frequency, **10 readings represents roughly 10 minutes.** The actual time depends on the readings received; delayed or missing readings can extend the time needed to accumulate that count. For other supported continuous devices, confirm the frequency rather than assuming one reading per minute.

**Notification timing** The **first reading that breaches** the temperature threshold **triggers a notification**. After that, notifications follow the configured sustained-reading count. If the **temperature drops below the threshold, the logic resets**. The next reading that breaches the threshold triggers a new notification, and sustained-reading evaluation begins again.

Select the comparison method

Open **Comparison Method** and select **All Values or Average**, as established by your clinical team. The screenshot illustrates All Values. The sustained-reading count applies to the evaluation window for the selected method. **All Values** **Each reading** in the sustained-reading window **must meet the threshold conditio**n. For a high-threshold rule, all values in the window must be above the high threshold; for a low-threshold rule, all values must be below the low threshold. This method looks for a condition sustained across the individual readings rather than an average. **Average** The **system calculates the average** of the readings in the **sustained-reading window and compares that average with the configured threshold.** The average can meet the condition even when some individual readings do not. A single out-of-range value does not necessarily make the average out of range.

**Temperature comparison and notification example** With a high threshold of **38.0 °C** and a sustained-reading count of **10**, assume nine consecutive readings are **38.2 °C**, followed by one reading of **37.8 °C**. 1. **First breach:** The first reading of 38.2 °C triggers a notification immediately. 2. **Sustained evaluation:** The following readings remain above the threshold, but the sustained-reading count of 10 has not yet been reached. 3. **Reset:** The reading of 37.8 °C falls below the threshold and resets the logic. 4. **Next breach:** If a later reading breaches the threshold again, it triggers a new notification. Sustained-reading evaluation then begins again. **How the comparison methods apply** - **All Values:** All 10 readings must exceed the high threshold. A reading below the threshold resets the logic. - **Average:** The average must exceed the high threshold, but a reading below the threshold still resets the logic. Although the nine readings of 38.2 °C and one of 37.8 °C average **38.16 °C**, they cannot be treated as a completed sustained-reading window across that reset. The sustained-reading count applies after the first-breach notification; it does not delay that initial notification.

Enter a description- Optional

The **Description** field is blank by default. If desired, enter a short label identifying the vital sign and purpose of the notification, such as *Continuous temperature high threshold*. Avoid describing the sustained-reading count as a fixed duration.

Review and update notification subscribers- Optional

Select the ellipsis (**…**) beside **Notification Subscribers** to review or update who receives notification alerts.

**Notification Subscribers** determine who receives an email when a notification is triggered. These emails are sent in addition to the notification bells displayed on the clinical dashboard. Review the default subscribers: - **Me:** The clinician assigning the notification. - **Patient:** The patient, who will receive emails if an email address is attached to their profile. 1. If applicable, deselect any default subscriber who should not receive email notifications. 2. To add another clinician, enter their username under **Cloud DX Users**. Each clinician must have an active account under the same clinic. To add multiple clinicians, enter a semicolon (**;**) after each username, for example: **username1;username2;username3**. 3. If you prefer **dashboard bells only**, deselect the default subscribers and ensure no additional subscribers are selected. 4. Once your selections are complete, select **Update**. **Group email addresses:** Contact your Deployment & Success Team (DST) representative if you would like to add a group email address.

**Recipient check:** Confirm that the configuration is directed to the intended care team. Notification recipients and clinical response responsibilities should follow your program’s established process.

Save the Notification

Review the result type, units, threshold values, sustained-reading count, comparison method, description, and subscribers. **Select Update** to save the configuration.

**TIPS** **Check data freshness**. Review the latest continuous reading timestamp and trend for gaps. Continuous monitoring does not guarantee that data is received without interruption. **Check reading frequency.** A sustained-reading count can represent different durations when transmission frequency changes or a different supported device is used. **Check the configuration state.** A paused configuration does not generate new notifications or notification emails for that rule. Other configurations for the patient continue to operate. **Check after resuming.** The sustained-reading window restarts using readings received after resuming. Previously accumulated readings are not carried forward. Do not assume every alert must wait for the full sustained count; first-breach behaviour may apply. **Clinical use** Notifications support your program’s monitoring workflow and do not replace clinical assessment. Follow your program’s review and escalation procedures; absence of a notification alone should not be interpreted as confirmation that the patient is stable.