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95 lines
4.4 KiB
Markdown
95 lines
4.4 KiB
Markdown
---
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name: case-summary
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description: Prepare a complete clinical case summary for a patient from FHIR endpoints. Use when asked to summarize a patient, compile a case, or prepare for tumor board.
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metadata:
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openclaw:
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requires:
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bins: ["python3"]
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---
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Prepare a complete case summary for $ARGUMENTS
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Use your fhir-basics skill to query the FHIR endpoints. Use your clinical-knowledge skill to flag abnormal values and identify relevant clinical context.
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## Steps
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1. **Find the patient** -- Query `GET /Patient?name={name}&_count=5` or `GET /Patient?_count=1` for "first patient". Extract `id`, full name, birthDate, gender.
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2. **Get active conditions** -- Query `GET /Condition?patient={id}&clinical-status=active`. Extract each condition's display name, SNOMED/ICD code, onset date, and verification status. Also query for resolved conditions and list them separately (they provide clinical history context).
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3. **Get recent labs** -- Query `GET /Observation?patient={id}&category=laboratory&_sort=-date&_count=50`. "Recent" means the most recent value for each distinct LOINC code within the past 12 months. For each lab, report: name, value, unit, date, and whether it's normal/abnormal per the clinical-knowledge skill. If the Observation includes a `referenceRange`, use that for flagging.
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4. **Get recent vitals** -- Query `GET /Observation?patient={id}&category=vital-signs&_sort=-date&_count=20`. For blood pressure, handle the component Observation format (LOINC 85354-9 panel with systolic/diastolic in `component[]`). Report the most recent BP, heart rate, BMI, temperature.
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5. **Get current medications** -- Query `GET /MedicationRequest?patient={id}&status=active`. For each medication, report: drug name, dosage text, and drug class (per clinical-knowledge skill). Organize by drug class when possible.
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6. **Get recent encounters** (optional but adds context) -- Query `GET /Encounter?patient={id}&_sort=-date&_count=5`. Report type, date, and reason if available. This shows how recently the patient was seen.
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7. **Compile the case summary** with these sections:
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- **Demographics**: Name, age (calculated from birthDate), gender, address if available
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- **Active Conditions**: With codes and onset dates
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- **Resolved Conditions** (if any): Brief list for clinical history
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- **Recent Labs**: Grouped by category (metabolic, lipids, renal, hematology), abnormal values highlighted
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- **Recent Vitals**: Most recent BP, HR, BMI
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- **Current Medications**: With drug class annotations
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- **Clinical Flags**: Any abnormal values, potential care gaps (e.g., diabetic patient without A1c in 12 months, hypertensive with uncontrolled BP), or comorbidity patterns worth noting
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8. **Disclaimer**: "This summary is auto-generated from FHIR data for research and operational use. Verify all information before clinical decision-making."
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## Output Format
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```
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============================================================
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PATIENT CASE SUMMARY
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============================================================
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Generated: {date/time}
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Source: {FHIR endpoint URL}
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DEMOGRAPHICS
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Name: {full name}
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Age: {age} years (DOB: {birthDate})
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Gender: {gender}
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ACTIVE CONDITIONS ({count})
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1. {display} (SNOMED {code}) -- onset {date}
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2. ...
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RESOLVED CONDITIONS ({count})
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1. {display} -- resolved
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RECENT LABS (most recent per test, past 12 months)
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Metabolic:
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HbA1c: {value}% ({date}) ⚠ ABOVE TARGET (>7.0%)
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Fasting Glucose: {value} mg/dL ({date}) -- Normal
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Renal:
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Creatinine: {value} mg/dL ({date}) -- Normal
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eGFR: {value} mL/min ({date}) -- Normal
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Lipids:
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LDL: {value} mg/dL ({date}) ⚠ ELEVATED (>100)
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...
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RECENT VITALS
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Blood Pressure: {systolic}/{diastolic} mmHg ({date})
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Heart Rate: {value} bpm ({date})
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CURRENT MEDICATIONS ({count})
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Diabetes:
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- Metformin 1000mg twice daily
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Antihypertensive:
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- Lisinopril 20mg daily
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Statin:
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- Atorvastatin 40mg daily
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CLINICAL FLAGS
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⚠ HbA1c 9.2% indicates poor glycemic control (CMS122 gap)
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⚠ LDL 165 mg/dL above target for diabetic patient
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✓ On statin therapy (appropriate for diabetes + elevated LDL)
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✓ On ACE inhibitor (appropriate for diabetes + hypertension)
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============================================================
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Disclaimer: This summary is auto-generated from FHIR data
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for research and operational use. Verify all information
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before clinical decision-making.
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============================================================
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```
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