Set vital thresholds
Per-patient vital ranges, alert tuning, and reasonable defaults for hypertension, CHF, and T2DM cohorts.
Thresholds are the rules Vantrexia uses to decide which readings become alerts. Get them right and your triage queue surfaces the patients who truly need attention. Get them wrong and you either drown in false alarms or miss real decompensation.
How thresholds resolve
Vantrexia applies thresholds in a strict priority order:
- Per-patient overrides (highest)
- Practice-wide defaults for Standard or Senior (75+) profiles
- System defaults (lowest, used only if neither of the above is set)
This means: set sensible practice-wide defaults once, then override at the patient level only when a particular patient's clinical baseline calls for it.
Practice-wide defaults
Open Settings -> Vital thresholds. The page shows two columns (Standard (under 75 years) and Senior (75+)) with a row per vital sign. The system defaults that ship out of the box are:
| Vital | Standard | Senior |
|---|---|---|
| Systolic BP min / max | 90 / 150 mmHg | 90 / 150 mmHg |
| Diastolic BP min / max | 60 / 90 mmHg | 60 / 90 mmHg |
| Pulse min / max | 50 / 120 bpm | 50 / 100 bpm |
| Glucose min / max | 70 / 180 mg/dL | 60 / 140 mg/dL |
| SpO2 min | 90% | 92% |
| Weight change | 2 kg / 7 days | 3 lbs / 24 hours |
There's also a separate critical buffer. How far past the warning threshold a reading needs to land before Vantrexia flags it as Critical rather than Warning. The defaults (20 mmHg systolic, 15 mmHg diastolic, 100 mg/dL glucose) work for most populations.
Senior thresholds are looser on systolic BP and tighter on glucose and SpO2. The typical clinical adjustment for an older, multi-morbid population. The age cutoff is configurable from this same screen.
Setting per-patient thresholds
Open the patient's profile and click the Thresholds tab.
For each vital you want to override, toggle Customize for this patient.
Enter a Min and Max value (or just Min for SpO2). Leave blank to keep the practice default.
Toggle Monitor this vital off entirely if a patient doesn't use a particular device. For example, an HTN-only patient who has no scale.
Click Save. Vantrexia logs the change in the patient's threshold-change audit log with your name and the values before and after.
Reasonable starting points by cohort
These are the defaults clinics most often pick when they tune at the patient level. Always validate against your patient's actual clinical picture.
Hypertension (HTN)
- Systolic BP: 110 – 150 mmHg for stage 1, 110 – 140 mmHg if you've decided on tighter control (e.g., post-stroke, CKD).
- Diastolic BP: 60 – 90 mmHg.
- Pulse: practice default. Tighten the upper bound to 100 bpm if the patient is on a beta-blocker and you want to monitor for bradycardia.
- Disable weight, glucose, and SpO2 monitoring unless they apply.
Congestive heart failure (CHF)
- Weight change: 3 lbs / 24 hours is the classic CHF decompensation flag, keep this on. Use the senior weight rule even for under-75 patients with CHF.
- Systolic BP: 100 – 140 mmHg, but coordinate with the cardiology plan, many CHF patients run lower.
- Pulse: 50 – 110 bpm. Tighten if the patient is on rate-control therapy.
- SpO2: ≥ 92% for most CHF patients.
Type 2 diabetes (T2DM)
- Fasting glucose: 70 – 180 mg/dL is a reasonable starting band. Tighten to 70 – 140 mg/dL for patients in good control or pre-pregnancy planning; loosen the upper bound to 250 mg/dL for new-onset patients still being titrated.
- Hypoglycemia floor: keep the critical low at 60 mg/dL. Anything below should always escalate.
- Disable BP, weight, and SpO2 unless the patient is also being monitored for those.
Mixed cohorts (HTN + CHF + T2DM)
Plenty of RPM patients carry all three diagnoses. Enable BP, weight, and glucose. Use the Senior preset as a starting point even if the patient is under 75. Its tighter weight rule and more conservative glucose band tend to fit a multi-morbid panel better than Standard.
What happens when a reading breaks a threshold
When a reading crosses a threshold, Vantrexia:
- Creates an alert with a severity (Warning or Critical) and posts it on the Triage dashboard.
- Notifies the patient's care team via the in-app notification bell and (optionally) email.
- Starts counting the staff time spent reviewing and resolving the alert toward the patient's monthly 99457 (first 20 minutes) and 99458 (each additional 20 minutes) totals.
See the Monitoring section for how to triage and resolve alerts.
A note on tuning
The single best signal that your thresholds are well-tuned is alert fatigue: if your nurse is clicking through more than ~10 alerts per patient per week and most of them resolve without action, the thresholds for those patients are too tight. Loosen them. The system records every change, so you can always tighten back later when you have more clinical context.