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Population Health
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Accepted chart labels
Human-confirmed labels that stay on the chart after a cohort membership is accepted.
0, active
No accepted chart labels yet. Cohort memberships and review tasks still appear below before anything is accepted.
Cohort memberships
Patient-list membership from saved cohort runs. These are source lists, not task status or accepted chart labels.
1, current
Smoking / Lung Screening review cohort
Chart evidence: Care element: smoking_status former smoker form
membership needs review
No review task has been created from this cohort for this patient yet.
Open review tasks
6
New, in review, or accepted tasks
Last visit
2025-05-13
Appointment or derived chart contact
Latest A1c
5.5 %
2024-04-25
Latest BP
137 mmHg / 73 mmHg
2025-10-19
Extracted signals
0
Optional text signals
Chart volume
37
7 notes, 2 reports
A compact view of what needs attention before opening the full imported record.
Review priority
1
active signal
6
0
0
Review these before relying on the imported record clinically.
Review needed
6 open flags
Open clinical review items need status, assignment, or closure.
Active problems
5
Sickle cell disease
D57.1
active
Generalized anxiety disorder
active
Colorectal cancer survivor
active
Asthma
J45.909
active
History of gestational diabetes
active
Active medications
4
Hydroxyurea
1000 mg daily
Folic acid
1 mg daily
Salbutamol inhaler
100 mcg 1-2 puffs q4h PRN
Metformin
850 mg daily
AI-CDS actions selected from Flags & Tasks. These stay visible on the chart for follow-up.
0, selected
No selected follow-up actions
Select AI-CDS actions from Flags & Tasks to keep them visible on this chart.
Saved population-health queue work for this patient: calls, recalls, flags, snoozes, exclusions, and completions.
Optional text-derived evidence extracted beside the imported chart. Each signal stays traceable to source text.
No extracted signals for this patient
Reprocess an import with text enrichment to attach suggested evidence to this patient record.
Most recent values are summarized here so the timeline can stay readable.
Recent chart, workflow, AI, cohort, and audit events shown in the user's local time.
23, more source rows below
Latest narrative evidence, clipped for scanning.
Recent report headers and excerpts.
Audit view for imported records. Kept collapsed so the working chart remains usable.
PHM saved action
PHM action: INFLUENZA_RECALL_DUE
status=outreach_planned | imported | next review=2026-07-17 | Review evidence for Influenza immunization recall; confirm appropriateness before contacting patient.
PHM saved action
PHM action: SICKLE_CELL_PREVENTIVE_REVIEW
status=booked | imported | next review=2026-06-23 | Review evidence for Sickle cell preventive care review; confirm appropriateness before contacting patient.
PHM saved action
PHM action: MODERATE_SEVERE_SYMPTOM_SCORE
status=in_review | imported | next review=2026-06-09 | Review evidence for Elevated mental health symptom score; confirm appropriateness before contacting patient.
PHM saved action
PHM action: ASTHMA_CONTROLLER_REVIEW
status=snoozed | imported | next review=2026-06-23 | Review evidence for Asthma controller therapy review; confirm appropriateness before contacting patient.
cohort_run
Cohort: Smoking / Lung Screening review cohort
completed | Chart evidence: Care element: smoking_status former smoker form | probable
clinical_flag
Possible diabetes monitoring care gap
new | medium | structured | Confirmed diabetes evidence found, but no recent A1c/HbA1c care element was imported.
phm_workflow
PHM action: INFLUENZA_RECALL_DUE
status=outreach_planned | imported | next review=2026-07-17 | Review evidence for Influenza immunization recall; confirm appropriateness before contacting patient.
phm_workflow
PHM action: SICKLE_CELL_PREVENTIVE_REVIEW
status=booked | imported | next review=2026-06-23 | Review evidence for Sickle cell preventive care review; confirm appropriateness before contacting patient.
phm_workflow
PHM action: MODERATE_SEVERE_SYMPTOM_SCORE
status=in_review | imported | next review=2026-06-09 | Review evidence for Elevated mental health symptom score; confirm appropriateness before contacting patient.
phm_workflow
PHM action: ASTHMA_CONTROLLER_REVIEW
status=snoozed | imported | next review=2026-06-23 | Review evidence for Asthma controller therapy review; confirm appropriateness before contacting patient.
clinical_flag
Influenza immunization recall
accepted | low | structured_fact | No recent influenza immunization evidence within the synthetic seasonal window.
clinical_flag
Age-eligible screening missing
dismissed | medium | clinical_note | Patient appears age-eligible for preventive screening, but no recent screening completion evidence is present.
clinical_flag
Sickle cell preventive care review
new | medium | clinical_note | Sickle cell disease requires review of vaccines, fever plan, hematology follow-up, pain plan, and hydroxyurea suitability.
clinical_flag
Elevated mental health symptom score
new | high | clinical_note | Recent note documents PHQ-9 22 and GAD-7 3; follow-up priority should be reviewed.
clinical_flag
Asthma controller therapy review
new | medium | clinical_note | Asthma symptoms or reliever pattern suggest controller therapy/adherence should be reviewed.
clinical_flag
Metformin without diabetes diagnosis
in_review | low | clinical_note | Active metformin exists without a diabetes problem-list diagnosis; likely legitimate but should be reviewed by cohort logic.
note
SOAP note
Asthma review. Symptoms: night cough twice weekly. Trigger avoidance and inhaler technique reviewed.
note
SOAP note
Metformin continued for history of gestational diabetes. No diagnosis of diabetes documented. HbA1c remains below diabetes threshold.
SOAP note
Asthma review. Symptoms: night cough twice weekly. Trigger avoidance and inhaler technique reviewed.
SOAP note
Metformin continued for history of gestational diabetes. No diagnosis of diabetes documented. HbA1c remains below diabetes threshold.
preventive care
Preventive care review: age-eligible cancer screening discussed. No completed screening result found in imported records.
SOAP note
Mental health review. PHQ-9 22, GAD-7 3. Sleep improving. No acute safety concern documented. Plan includes counselling resources, medication review, and follow-up interval based on symptoms.
Laboratory
CBC and hemolysis markers reviewed for sickle cell disease monitoring.
Consult
Oncology follow-up for colorectal cancer survivor. No active recurrence noted in this synthetic report. Ongoing surveillance, late effects, and primary care coordination discussed.
Possible diabetes monitoring care gap
Confirmed diabetes evidence found, but no recent A1c/HbA1c care element was imported.
Influenza immunization recall
No recent influenza immunization evidence within the synthetic seasonal window.
Age-eligible screening missing
Patient appears age-eligible for preventive screening, but no recent screening completion evidence is present.
Sickle cell preventive care review
Sickle cell disease requires review of vaccines, fever plan, hematology follow-up, pain plan, and hydroxyurea suitability.
Elevated mental health symptom score
Recent note documents PHQ-9 22 and GAD-7 3; follow-up priority should be reviewed.
Asthma controller therapy review
Asthma symptoms or reliever pattern suggest controller therapy/adherence should be reviewed.
Metformin without diabetes diagnosis
Active metformin exists without a diabetes problem-list diagnosis; likely legitimate but should be reviewed by cohort logic.
Smoking Status
former smoker
2026-04-10Diastolic Bp
73 mmHg
2025-10-19Systolic Bp
137 mmHg
2025-10-19Bmi
22.4 kg/m2
2025-07-26Immunization
Influenza vaccine documented
2024-08-11Diastolic Bp
Date | Type | Title | Detail |
|---|---|---|---|
cohort_run | Cohort: Smoking / Lung Screening review cohort | completed | Chart evidence: Care element: smoking_status former smoker form | probable | |
clinical_flag | Possible diabetes monitoring care gap | new | medium | structured | Confirmed diabetes evidence found, but no recent A1c/HbA1c care element was imported. | |
phm_workflow | PHM action: INFLUENZA_RECALL_DUE | status=outreach_planned | imported | next review=2026-07-17 | Review evidence for Influenza immunization recall; confirm appropriateness before contacting patient. | |
phm_workflow | PHM action: SICKLE_CELL_PREVENTIVE_REVIEW | status=booked | imported | next review=2026-06-23 | Review evidence for Sickle cell preventive care review; confirm appropriateness before contacting patient. | |
phm_workflow | PHM action: MODERATE_SEVERE_SYMPTOM_SCORE | status=in_review | imported | next review=2026-06-09 | Review evidence for Elevated mental health symptom score; confirm appropriateness before contacting patient. | |
phm_workflow | PHM action: ASTHMA_CONTROLLER_REVIEW | status=snoozed | imported | next review=2026-06-23 | Review evidence for Asthma controller therapy review; confirm appropriateness before contacting patient. | |
clinical_flag | Influenza immunization recall | accepted | low | structured_fact | No recent influenza immunization evidence within the synthetic seasonal window. | |
clinical_flag | Age-eligible screening missing | dismissed | medium | clinical_note | Patient appears age-eligible for preventive screening, but no recent screening completion evidence is present. | |
clinical_flag | Sickle cell preventive care review | new | medium | clinical_note | Sickle cell disease requires review of vaccines, fever plan, hematology follow-up, pain plan, and hydroxyurea suitability. | |
clinical_flag | Elevated mental health symptom score | new | high | clinical_note | Recent note documents PHQ-9 22 and GAD-7 3; follow-up priority should be reviewed. | |
clinical_flag | Asthma controller therapy review | new | medium | clinical_note | Asthma symptoms or reliever pattern suggest controller therapy/adherence should be reviewed. | |
clinical_flag | Metformin without diabetes diagnosis | in_review | low | clinical_note | Active metformin exists without a diabetes problem-list diagnosis; likely legitimate but should be reviewed by cohort logic. | |
note | SOAP note | Asthma review. Symptoms: night cough twice weekly. Trigger avoidance and inhaler technique reviewed. | |
note | SOAP note | Metformin continued for history of gestational diabetes. No diagnosis of diabetes documented. HbA1c remains below diabetes threshold. | |
care_element | smoking_status | former smoker | |
note | preventive care | Preventive care review: age-eligible cancer screening discussed. No completed screening result found in imported records. | |
report | Laboratory | CBC and hemolysis markers reviewed for sickle cell disease monitoring. | |
note | SOAP note | Mental health review. PHQ-9 22, GAD-7 3. Sleep improving. No acute safety concern documented. Plan includes counselling resources, medication review, and follow-up interval based on symptoms. | |
care_element | systolic_bp | ||
care_element | diastolic_bp | ||
note | consult | Survivorship care reviewed for history of colorectal cancer survivor. Patient asks about surveillance schedule and late effects. | |
care_element | bmi | ||
report | Consult | Oncology follow-up for colorectal cancer survivor. No active recurrence noted in this synthetic report. Ongoing surveillance, late effects, and primary care coordination discussed. | |
note | SOAP note | Sickle cell follow-up. Vaso-occlusive pain episodes in past year: 1. Reviewed hydration, fever precautions, vaccination status, and hematology follow-up. | |
appointment | chronic disease review | completed | |
care_element | immunization | Influenza vaccine documented | |
care_element | systolic_bp | ||
care_element | diastolic_bp | ||
care_element | hba1c | ||
note | SOAP note | Follow-up visit. Medication list reviewed, allergies checked, and preventive care status discussed. Patient reports recent family stress. Plan: update labs/vitals and arrange follow-up as clinically indicated. | |
care_element | systolic_bp | ||
care_element | diastolic_bp | ||
appointment | periodic health review | completed | |
care_element | hba1c | ||
appointment | medication renewal | no_show | |
care_element | hba1c | ||
appointment | chronic disease review | no_show |
75 mmHg
2024-05-26Systolic Bp
116 mmHg
2024-05-26Hba1c
5.5 %
2024-04-25Diastolic Bp
75 mmHg
2023-07-13Systolic Bp
113 mmHg
2023-07-13Hba1c
5.4 %
2022-11-15Hba1c
5.3 %
2021-01-21