A physician's office finishes a patient's orders late in the afternoon. The signature is done. As far as the physician is concerned, the next step belongs to the agency. At the agency, the office is winding down. The order arrives by fax or portal. Someone sees it, or doesn't. A question comes up about a detail, and the physician's office has already closed for the day. By the next morning, the order has been sitting for hours, the family is waiting, and nobody has the full p