From a connected EHR, a coordinator finds the patient, browses their encounters and imports an encounter with its clinical note, which arrives as a visit ready for CTCAE grading. The note is read from the encounter's FHIR DocumentReference, whether the text is attached inline as encoded content or stored as a separate binary file. The import step shows the field mapping and any conflict with a record already on file before it commits. Notes from systems with no FHIR connection come in by paste or file upload, and a visit can be recorded and turned into a note. Once a note is in, the engine extracts each adverse event, grades it to the CTCAE version the protocol names, codes it to MedDRA and attributes it per drug, and every grade traces to the line in the note that produced it.