How ADHD.ME uses automated decision-making

What information is used

ADHD.ME reads what your practice has already recorded about you: when you last attended, appointments you have booked, whether you have opted out, the ongoing-care conditions your practice has flagged on your record, and referrals your practice has written. Some of that is health information. It is used to decide who to invite to an appointment and when — never to work anything out about your health.

ADHD.ME does not read your consultation notes, test results or clinical correspondence, and does not receive them.

What is automated

• Whether you are in the group we deliberately leave alone. To know whether any of this helps, a share of patients at each practice is set aside and not sent availability messages at all. Which group you are in is worked out by a calculation on your patient number that always gives the same answer, not by anything about you or your health, and your practice sets the size of the group. Being in it does not change your care or your ability to book an appointment in the usual way; it means the practice is not messaging you about spare slots.
• Whether you may be offered an available appointment. Deterministic rules your practice configures: how recently you attended, appointments you already have, how often you have been contacted, consent and opt-out status. The rules are versioned and every exclusion is recorded with its reason, so your practice can ask why any single patient was or was not included.
• Whether you are on a register your practice runs. Membership is taken from the flag your practice has already recorded on your file, or added by the practice itself. It is never worked out from symptoms, medicines or anything else about you, and the source of every membership is recorded.
• When a scheduled appointment comes round. A calendar calculation against the interval your practice has set for that register — the time elapsed since a recorded date, not a judgement about whether you need to be seen. Your practice can also require this before anybody is contacted, which narrows who is messaged rather than widening it.
• Who is offered a slot first. Patients already found eligible are put in an order using simple, explainable factors — whether your practice has flagged you for ongoing care, and how long since your last visit. It decides the order of offers, never who is more unwell.
• Which GP the offer names. An offer normally names your usual GP. If your practice has turned this on for a particular register, and your usual GP does not meet the threshold that practice has set, the offer may name a different GP at the same practice instead. It never sends you outside your own practice, it never moves you when your usual GP does meet the threshold, and every such decision is recorded with its reason. Your practice sets a limit on how much of this can happen at all.
• Decisions not to contact you. Just as often the automated decision is silence: if your practice already has its own recall running for you, if you have had as many invitations as your practice allows, if the appointment would be gone before the hours you agreed to be contacted in, or if a practice-wide safety threshold has paused sending. Silence is recorded with its reason in the same way a message is.
• How and when a message actually goes out. Batch sizes, the wording template your practice has approved, and expiry of an offer once the session fills. An offer that has lapsed cannot be booked, which is the only way software here ever closes a door — and the appointment was gone in any case.
• Whether something you did is put in front of your GP. Four things take you out of the automated loop and to your usual GP: replying to a message in your own words, a complaint being logged, repeatedly not attending appointments the software offered, and opting out with a message attached. The software reads none of it. It notices that you wrote something or that something happened, and hands it to a person, because an automated loop is the wrong thing to be talking to.
• Whether you are reminded about a referral that has not completed. Where your practice has written you a referral and nothing has come back, the software can notice that and offer you an appointment with your own practice to sort it out. It is the same availability message as any other and says nothing about why. It never contacts the other practice about you and never chases you about your health.
• Whether how full a session looks changes how many people are messaged. SWITCHED OFF, and nothing has ever been sent from here in any case. If it were switched on, a session that looked like it would run under-full would mean more invitations went out to cover the gap — so it would change how many people are contacted, though never which people or in what order. Your practice can only switch it on by recording who decided and why; there is no setting that turns it on quietly. It is written down while it is off so the shape of the decision can be argued with before anybody is affected by it. One thing your practice should know when weighing it: the order invitations go out in is the subject of an open contradiction in this product's own published notice (recorded as MATCH-1), and sending more of them sends more through whatever that ordering is doing.
• What the record shows happened to your referral. The software forms a verdict on each referral — whether the record contains an appointment, a completion, or nothing yet — so a practice can see what has not closed. The verdict is a statement about which facts were recorded, never about whether the care was right, and "nothing recorded" is kept distinct from "nothing happened" because they are different.
• Whether something in your record counts as an answer to something we did. Built and not in use. Where your practice sent you an availability message or wrote a referral, the software can link a later recorded fact — a booking, an attendance, a decline, an opt-out — to the thing that came before it, so the practice can see what its own actions led to. It links only facts somebody wrote down, only where the later fact comes after the earlier one, and only kinds it has been told to expect. Where nothing is recorded it says nothing is recorded: that is never read as you having declined, ignored us, or made any choice at all. Nothing in it is a judgement about you or your health, and no page in the product shows it yet.
• Whether the facts on your file match a pathway your practice signed off. Built and not in use. Where a practice adopts a care pathway, the software compares facts already recorded on your file against the criteria in that pathway and flags the pathway for the practice to look at, including criteria that ask a clinician to look sooner. It reaches no conclusion about your health, it reads nothing but facts somebody recorded, and where a fact is missing it says so rather than assuming. No pathway has been signed off for use, so this decision is not currently being taken about anybody.

What is never automated

• No clinical decision of any kind — no diagnosis, no triage, no assessment of symptoms.
• No decision to deny care: not being sent an availability message never affects your ability to book through the practice as usual.
• No inference about you. Nothing is concluded from your details that you or your practice did not record. Where a reason for something is held, somebody said it.
• No ordering of patients by need or by how unwell they are, and no list of who is most at risk. ADHD.ME decides who has an appointment offered to them, never who most needs one.
• No decision that your care has moved to another clinician. When your GP refers you, the receiving practice must record that it has taken you on; silence is never read as a handover.
• Nothing you are sent reveals why you were selected. A message prompted by a register or by a referral is word for word the same as any other appointment invitation.
• No automated re-enabling of contact after you opt out. Opt-out is permanent.

Human controls

• The practice configures and can change every eligibility rule at any time.
• Every register, and the routing described above, is off unless your practice turns it on.
• Practice staff can pause all sending instantly with one switch.
• Your practice approves the exact wording of every message before any of it can be sent, and an edit of a single character withdraws that approval.
• You can stop all messages by replying STOP, and can ask your practice to access or delete the information ADHD.ME holds.
• Every automated action is written to an audit log the practice can inspect.