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extremely promising for real world applications. V.INTRODUCTION Clinical alert systems (CAS) have been used to analyze deviations from hospital standards in the electronic medical record to identify missing documentations and send alerts to the appropriate providers to increase adherence to required elements. To improve compliance, an alert system for documentation of the Immediate Preoperative Assessment (IPOA) was implemented at our institution in August 2018 with the goal of improving documentation compliance rates. We hypothesized tha