We would like to request clarification on the following logic associated with patient refusal, "LastED.relevantPeriod ends 1 hour or less on or before VisitStart" for patients that are admitted to observation prior to inpatient encounter.

Patients in a status of observation may remain physically within the ED department. We believe there are appropriate times when an observation encounter and ED encounter times overlap. In that event, patients that refuse prophylaxis during the ED may fail the criteria because ED end does not occur at same time as or within an hour of Observation begin.