Stage 6 — DISPATCH

What happens

Dispatch runs asynchronously after the FHIR write succeeds. Three things happen concurrently:

1. FHIR subscription fan-out — SubscriptionEventDispatcher evaluates 17 seeded subscriptions
2. JamConnect POST_WRITE — clinical intelligence event routing
3. DHIS2 push — for notifiable disease LOINC codes (optional)

FHIR subscriptions

JamBridge ships with 17 seeded FHIR subscriptions that cover common hospital chain scenarios:

#	Criteria	Channel	Purpose
1–3	Patient?	MLLP to other branches	Cross-branch patient sync
4–6	Encounter?	FHIR REST	Encounter propagation
7–9	Observation?code=CBC	FHIR REST	Critical lab result routing
10–12	MedicationRequest?	FHIR REST	Pharmacy notification
13–14	DiagnosticReport?	SMS	CHW alerts
15–17	Condition?	FHIR REST	Disease surveillance

Custom subscriptions can be added via the JamBridge admin API.

JamConnect POST_WRITE

After every successful FHIR write, JamBridge fires a POST_WRITE event to JamConnect:

POST /jamconnect/events
Host: jamconnect:8091

{
  "eventType": "POST_WRITE",
  "resourceType": "Patient",
  "patientGoldenId": "GOLDEN-00441",
  "facilityCode": "BRANCH-01",
  "transactionId": "BR01-26060612-001"
}

JamConnect evaluates its rule engine (5 rules per event in virtual threads):

• IPS cache invalidation in JamSHR
• CDS Hooks dispatch to clinician portals
• Critical value alerts to clinical staff
• Escalation timer start
• DHIS2 surveillance triggers

DHIS2 surveillance

When an ORU message contains a notifiable LOINC code (dengue, malaria, TB, cholera), JamBridge pushes a data value to DHIS2:

POST /api/dataValueSets
Host: dhis2

{
  "dataValues": [{
    "dataElement": "DE_DENGUE_NS1",
    "period": "20260612",
    "orgUnit": "OU_BRANCH_01",
    "value": "positive"
  }]
}

This is non-blocking — a DHIS2 failure does not affect the pipeline or the ACK.