Loading program cohort

Loading matching patients, related flags, and saved follow-up actions.

Building the scoped cohort view

Upload

Ask

Disease program

Diabetes / Prediabetes in docchart_synthetic_population_300.json

Scoped to Import: docchart_synthetic_population_300.json: matching patients, related flags, and DB-saved AI-CDS follow-up actions.

Programs

Cohort builder

Ask

Patient scope

Choose whether this program should search the whole clinic or only one import panel. Use this for the latest 300-patient JSON import.

300, panel patients

All clinic patients docchart_synthetic_population_300.json (300)docchart_synthetic_population_300.json (300)synthetic-100-longitudinal.xml (100)sample-omd.xml (0)

Matching patients

106

Within selected import panel

Program flags

111

111 grouped under patients

Follow-up actions

0

0 DB-saved actions

Program state

Active

Flags create AI-CDS follow-up actions

Diabetes / Prediabetes Worklist

Patient-centric program list scoped to Import: docchart_synthetic_population_300.json.

122, patients

122 matching patients136 program flags and 0 saved follow-up actions grouped under patients

Loading...

1-25 of 122

Rows

Select

Page 1 / 5

Loading...

122 matching patients136 program flags and 0 saved follow-up actions grouped under patients

Loading...	Loading...	Loading...	Evidence	Loading...	Loading...	Action
Cooper, Cathy DOB 1971-01-20	Juliana Davies	2026-05-14	Diabetic eye screening risk \| Type 2 diabetes mellitus \| Metformin XR	Possible diabetes monitoring care gap new Urine ACR overdue in_review +,1, more	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Noble, Jerry DOB 1967-08-01	Amina Farah	2026-05-03	Type 2 diabetes mellitus \| Metformin	Possible diabetes monitoring care gap new Urine ACR overdue in_review +,1, more	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Bailey, Troy DOB 1938-01-21	Wole Oduntan	2026-04-12	Type 2 diabetes mellitus	Urine ACR overdue in_review HbA1c above target in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Boyer, Christina DOB 1959-04-17	Wole Oduntan	2026-04-29	Diabetic eye screening risk \| Type 2 diabetes mellitus \| Metformin	Urine ACR overdue new HbA1c above target accepted	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Brown, Richard DOB 1985-10-09	Eric Lavoie	2025-07-14	Diabetic retinopathy \| Type 2 diabetes mellitus	Possible diabetes monitoring care gap new HbA1c above target dismissed	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Brown, Todd DOB 1963-02-18	Eric Lavoie	2023-11-14	Prediabetes	Possible diabetes monitoring care gap new Prediabetes range HbA1c accepted	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Crawford, Michael DOB 1948-10-01	Eric Lavoie	2026-03-06	Type 2 diabetes mellitus \| Metformin XR	Urine ACR overdue accepted HbA1c above target in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Cruz, Megan DOB 1971-07-12	Eric Lavoie	2026-03-16	Type 2 diabetes mellitus \| Metformin	Urine ACR overdue accepted HbA1c above target new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Cunningham, Justin DOB 1991-08-06	Wole Oduntan	2026-04-25	Prediabetes	Possible diabetes monitoring care gap new Prediabetes range HbA1c accepted	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Eaton, Phillip DOB 1982-07-21	Wole Oduntan	2026-05-17	Diabetic eye screening risk \| Type 2 diabetes mellitus	Possible diabetes monitoring care gap new Urine ACR overdue new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Erickson, Robert DOB 1953-04-14	Juliana Davies	2026-02-20	Type 2 diabetes mellitus	Urine ACR overdue in_review HbA1c above target completed	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Francis, Tammy DOB 1947-05-02	Amina Farah	2025-01-17	Type 2 diabetes mellitus \| Metformin	Urine ACR overdue in_review HbA1c above target completed	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Garcia, Manuel DOB 1948-12-06	Wole Oduntan	2023-04-18	Type 2 diabetes mellitus \| Metformin	Urine ACR overdue new HbA1c above target new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Hill, Isabella DOB 1989-07-25	Melinda Chu	2026-04-03	Type 2 diabetes mellitus \| Metformin XR	Urine ACR overdue new HbA1c above target in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Holt, Dustin DOB 1963-02-16	Melinda Chu	2026-03-02	Prediabetes	Possible diabetes monitoring care gap new Prediabetes range HbA1c dismissed	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Johnson, Johnny DOB 1956-08-28	Melinda Chu	2022-06-17	Prediabetes	Possible diabetes monitoring care gap new Prediabetes range HbA1c new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Johnson, Tommy DOB 1948-01-26	Melinda Chu	2026-02-14	Diabetic retinopathy \| Type 2 diabetes mellitus \| Metformin \| Metformin XR	Urine ACR overdue accepted HbA1c above target completed	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Little, Brian DOB 1960-04-22	Amina Farah	2026-05-09	Type 2 diabetes mellitus \| Metformin	Possible diabetes monitoring care gap new HbA1c above target new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Mendoza, Eric DOB 1951-06-20	Melinda Chu	2026-04-30	Type 2 diabetes mellitus \| Metformin	Possible diabetes monitoring care gap new Urine ACR overdue new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Moore, Stephanie DOB 1981-06-24	Eric Lavoie	2025-06-08	Prediabetes	Possible diabetes monitoring care gap new Prediabetes range HbA1c in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Moore, Stephen DOB 1957-04-19	Eric Lavoie	2026-04-26	Diabetic retinopathy \| Type 2 diabetes mellitus \| Metformin	Possible diabetes monitoring care gap new Urine ACR overdue in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Murphy, Megan DOB 1982-06-24	Eric Lavoie	2026-03-18	Diabetic eye screening risk \| Type 2 diabetes mellitus \| Metformin	Urine ACR overdue accepted HbA1c above target new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Myers, Joy DOB 1975-01-18	Eric Lavoie	2026-03-28	Diabetic eye screening risk \| Type 2 diabetes mellitus \| Metformin	Urine ACR overdue in_review HbA1c above target accepted	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Orr, Mitchell DOB 1961-12-06	Melinda Chu	2026-04-03	Type 2 diabetes mellitus \| Metformin XR	Urine ACR overdue accepted HbA1c above target new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...
Perez, Robert DOB 1975-04-06	Eric Lavoie	2025-05-13	History of gestational diabetes \| Metformin	Possible diabetes monitoring care gap new Metformin without diabetes diagnosis in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Loading...

Loading...

1-25 of 122

Rows

Select

Page 1 / 5

Loading...	Loading...	Loading...	Evidence	Loading...	Loading...	Action
Cooper, Cathy DOB 1971-01-20	Juliana Davies	2026-05-14	Diabetic eye screening risk \| Type 2 diabetes mellitus \| Metformin XR	Possible diabetes monitoring care gap new Urine ACR overdue in_review +,1, more	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Noble, Jerry DOB 1967-08-01	Amina Farah	2026-05-03	Type 2 diabetes mellitus \| Metformin	Possible diabetes monitoring care gap new Urine ACR overdue in_review +,1, more	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Bailey, Troy DOB 1938-01-21	Wole Oduntan	2026-04-12	Type 2 diabetes mellitus	Urine ACR overdue in_review HbA1c above target in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Boyer, Christina DOB 1959-04-17	Wole Oduntan	2026-04-29	Diabetic eye screening risk \| Type 2 diabetes mellitus \| Metformin	Urine ACR overdue new HbA1c above target accepted	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Brown, Richard DOB 1985-10-09	Eric Lavoie	2025-07-14	Diabetic retinopathy \| Type 2 diabetes mellitus	Possible diabetes monitoring care gap new HbA1c above target dismissed	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Brown, Todd DOB 1963-02-18	Eric Lavoie	2023-11-14	Prediabetes	Possible diabetes monitoring care gap new Prediabetes range HbA1c accepted	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Crawford, Michael DOB 1948-10-01	Eric Lavoie	2026-03-06	Type 2 diabetes mellitus \| Metformin XR	Urine ACR overdue accepted HbA1c above target in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Cruz, Megan DOB 1971-07-12	Eric Lavoie	2026-03-16	Type 2 diabetes mellitus \| Metformin	Urine ACR overdue accepted HbA1c above target new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Cunningham, Justin DOB 1991-08-06	Wole Oduntan	2026-04-25	Prediabetes	Possible diabetes monitoring care gap new Prediabetes range HbA1c accepted	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Eaton, Phillip DOB 1982-07-21	Wole Oduntan	2026-05-17	Diabetic eye screening risk \| Type 2 diabetes mellitus	Possible diabetes monitoring care gap new Urine ACR overdue new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Erickson, Robert DOB 1953-04-14	Juliana Davies	2026-02-20	Type 2 diabetes mellitus	Urine ACR overdue in_review HbA1c above target completed	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Francis, Tammy DOB 1947-05-02	Amina Farah	2025-01-17	Type 2 diabetes mellitus \| Metformin	Urine ACR overdue in_review HbA1c above target completed	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Garcia, Manuel DOB 1948-12-06	Wole Oduntan	2023-04-18	Type 2 diabetes mellitus \| Metformin	Urine ACR overdue new HbA1c above target new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Hill, Isabella DOB 1989-07-25	Melinda Chu	2026-04-03	Type 2 diabetes mellitus \| Metformin XR	Urine ACR overdue new HbA1c above target in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Holt, Dustin DOB 1963-02-16	Melinda Chu	2026-03-02	Prediabetes	Possible diabetes monitoring care gap new Prediabetes range HbA1c dismissed	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Johnson, Johnny DOB 1956-08-28	Melinda Chu	2022-06-17	Prediabetes	Possible diabetes monitoring care gap new Prediabetes range HbA1c new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Johnson, Tommy DOB 1948-01-26	Melinda Chu	2026-02-14	Diabetic retinopathy \| Type 2 diabetes mellitus \| Metformin \| Metformin XR	Urine ACR overdue accepted HbA1c above target completed	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Little, Brian DOB 1960-04-22	Amina Farah	2026-05-09	Type 2 diabetes mellitus \| Metformin	Possible diabetes monitoring care gap new HbA1c above target new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Mendoza, Eric DOB 1951-06-20	Melinda Chu	2026-04-30	Type 2 diabetes mellitus \| Metformin	Possible diabetes monitoring care gap new Urine ACR overdue new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Moore, Stephanie DOB 1981-06-24	Eric Lavoie	2025-06-08	Prediabetes	Possible diabetes monitoring care gap new Prediabetes range HbA1c in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Moore, Stephen DOB 1957-04-19	Eric Lavoie	2026-04-26	Diabetic retinopathy \| Type 2 diabetes mellitus \| Metformin	Possible diabetes monitoring care gap new Urine ACR overdue in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Murphy, Megan DOB 1982-06-24	Eric Lavoie	2026-03-18	Diabetic eye screening risk \| Type 2 diabetes mellitus \| Metformin	Urine ACR overdue accepted HbA1c above target new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Myers, Joy DOB 1975-01-18	Eric Lavoie	2026-03-28	Diabetic eye screening risk \| Type 2 diabetes mellitus \| Metformin	Urine ACR overdue in_review HbA1c above target accepted	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Orr, Mitchell DOB 1961-12-06	Melinda Chu	2026-04-03	Type 2 diabetes mellitus \| Metformin XR	Urine ACR overdue accepted HbA1c above target new	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...
Perez, Robert DOB 1975-04-06	Eric Lavoie	2025-05-13	History of gestational diabetes \| Metformin	Possible diabetes monitoring care gap new Metformin without diabetes diagnosis in_review	Ask AI-CDS for actions next step No saved action yet. Starts AI-CDS review on the next page.	Open chart Loading...

Open chart