# Signals with Ovok gotchas

Canonical page: https://docs.ovok.com/signals/with-ovok/gotchas

## Which readings reach Signals [#which-readings-reach-signals]

- **Your project needs its own Signals tenant.** On the shared tenant, both [settings](/signals/with-ovok/settings) stay off and turning one on answers `409` `SETTING_NOT_AVAILABLE`.
- **Only created Observations.** `SIGNALS_SEND_AUTO` sends an Observation when it is created through the FHIR API. Updating one sends nothing. To correct a reading, create a new Observation.
- **Some are skipped.** An Observation whose `subject` is not a `Patient`, one with `status` `entered-in-error` or `cancelled`, and one carrying an `ovok-event-id` or Signals identifier are not sent.
- **Ingest is separate.** Readings from [Data Ingestion](/data-ingestion) are sent by the ingest path, whatever `SIGNALS_SEND_AUTO` says. Turning the setting off does not stop them.
- **The first reading enrols the patient.** You need [`$enable-signals`](/signals/enable-signals-patient) only to enrol a patient before any reading, for example to set their thresholds first.
- **The same reading twice is judged once.** Signals ignores a reading it already has within an hour.

## Retries and gaps [#retries-and-gaps]

- **About 34 minutes of retries.** If Ovok or Signals is down, the notification for a new Observation is retried for about 34 minutes. A longer outage loses that reading for Signals. The Observation stays in FHIR; it is not sent again later, and nothing replays it.
- **Deleting the Subscription stops sending.** The Subscription tagged `signals-send-auto` is Ovok's. If it is deleted through the FHIR API, sending stops for the project; save `SIGNALS_SEND_AUTO` again to re-create it.
- **No backfill.** `SIGNALS_ANNOTATE_OBSERVATIONS` writes alerts raised after it is turned on, not earlier ones.

## Alerts, episodes and annotations [#alerts-episodes-and-annotations]

- **Episodes need `episodicAlerts`.** With it off for your tenant, Signals records no episodes: you get `DetectedIssue`s but no `Flag`s, and episode feeds stay empty. Turning it off empties them.
- **Coarse grading.** `severity` is always `moderate`, and `interpretation` is only `H`, `L` or `A`. Signals' bands have no critical limits, so there is no `HH` or `LL`.
- **Not every alert has a reading.** A reading Ovok did not keep in FHIR, such as a realtime tick from a device, gives a `DetectedIssue` with no `implicated`. Note, empty-reading and inactivity alerts never annotate an Observation.
- **Events can arrive out of order.** Ovok merges them by Signals' alert version, so the stored `DetectedIssue` is always the newest. `implicated` and `mitigation` only grow, and a closed `Flag` never reopens.
- **Old Flags.** Projects that used Ovok before 2026-10-15 can hold Flags from an older Ovok marker. Search episodes with `identifier=https://signals.actimi.com/episode|`.
- **Patients created through the standalone API.** Annotations cover every alert of your tenant and name the patient as `Patient/<refId>`. For a patient you create through the [standalone API](/signals/standalone), use its FHIR Patient id as `refId`, or its `DetectedIssue` points at no Patient. A project that uses only the standalone API should switch both settings off.

## Writing and access [#writing-and-access]

- **Don't write `DetectedIssue` or `Flag` yourself.** Ovok owns them, and a raw write never reaches Signals. Acknowledge an alert through the Slim [notification routes](/slim-apis/notifications/acknowledge-medical-notification) or the standalone [acknowledge route](/signals/standalone/api/alerts/acknowledge-an-alert-or-an-episode); the `DetectedIssue` then gains an `Acknowledged` mitigation.
- **Thresholds live in Signals.** Change them through the Slim [threshold routes](/slim-apis/threshold/get-patient-effective-threshold-v2). Editing a `Goal` or `CarePlan` directly never reaches Signals.
- **Grant read on `DetectedIssue` and `Flag`.** Roles that should see alerts need both in their access policy. Integration applications have them; Manager and Submitter applications hold Signals capabilities only.
- **`$enable-signals` needs two grants.** The caller needs `signals_config:update` and Patient `update`. Project admins have both; a new Manager or integration application has only one.

## Related [#related]

- [Signals settings](/signals/with-ovok/settings)
- [Alerts in FHIR](/signals/with-ovok/fhir-annotations)
- [Signals with Ovok](/signals/connected-ovok)