Synthetic data prototype — no PHI. Numbers, names, and IDs are fabricated for design review only.

Patient 360

Longitudinal Episode View

Search a synthetic patient or episode to inspect discharge → TCM → PCM → billing → outcomes end-to-end.

Wilhelmina Xanthopoulos

PT-000073 · USC-900122 · EPI-2026-0073

Referral BlockedLow riskMedicareProstate Cancer

Referral CenterReferral CenterSpecialty ReferralAI 46%SOB Cardiology PathwayReferral - BlockedPCMSpecialist ReferralAPCM

NBA: Resolve documents/intake blocker before outreach

Reason codes: DOCS_INCOMPLETE

Outreach

PCM Min.

Paid $

$69

Age / Sex

77 · F

ZIP

90070

Language

English

Payer

Medicare FFS

Procedure

Robotic Prostatectomy

Surgeon

Dr. Daniel Park

Surgery Site

USC Urology Beverly Hills

Surgery Date

Jan 24, 2026

Discharge

Jan 24, 2026

LOS

Status

Referral Blocked

Consent

On file

Episode Timeline

52 events

Surgery · Robotic Prostatectomy

2026-01-24

Dr. Daniel Park

Discharge · LOS 0d

2026-01-24

Intake Trigger · Specialty Referral · Independent PCP

2026-01-24 12:45

Not yet routed

AI Detection · AI score 46%

2026-01-24 12:45

DOCS_INCOMPLETE

Program Assignment · Specialist Referral · Eligible

2026-01-24 12:45

Not accepted (Pass payer check)

Referral Received · Pulmonology · Abnormal chest imaging

2026-01-24 12:45

External System · Dr. Patel Independent Practice

Intake Created · Intake REF-0023

2026-01-24 12:45

Urgency: Routine

PCM Offered · Pre-visit PCM offered

2026-01-24 12:45

Order Set Generated · SOB Cardiology Pre-Visit Bundle

2026-01-24 12:45

Program Assignment · APCM · Eligible

2026-01-25 12:45

Not accepted (Pass payer check)

Order Set · SOB Cardiology Pre-Visit Bundle · Cancelled

2026-01-25 12:45

4 orders · review complete

Program Assignment · PCM · Eligible

2026-01-26 12:45

Not accepted (Pass payer check)

Outreach Started · First contact attempt

2026-01-27 10:45

3d from referral

Outreach · Attempt 1 · TCM Accepted

2026-01-27 13:15

Jamal Carter

Workup Ordered · 12-lead EKG

2026-01-29

EKG

Workup Ordered · BNP

2026-01-29

Lab

Exception · Pre-Visit Readiness Blocked · Low · Open

2026-01-29 11:45

Derek Mensah

Exception Opened · Pre-Visit Readiness Blocked

2026-01-29 11:45

Low · Open

Workup Ordered · Ambulatory cardiac telemetry (ROCT)

2026-01-30

Imaging

Workup Scheduled · BNP

2026-01-30

Steerage · Procedure → External

2026-01-31

Community Health LA (External)

Steerage · Lab → External

2026-01-31

Pacific Imaging (External)

Workup Completed · 12-lead EKG

2026-01-31

Final

Workup Completed · BNP

2026-01-31

Final

Workup Ordered · Troponin

2026-01-31

Lab

Workup Scheduled · 12-lead EKG

2026-02-03

Workup Scheduled · Ambulatory cardiac telemetry (ROCT)

2026-02-04

Steerage · Imaging → USC

2026-02-06

USC Urology Beverly Hills

Workup Completed · Ambulatory cardiac telemetry (ROCT)

2026-02-06

Final

Downstream USC Service · Imaging

2026-02-06

Workup Ordered · Records request

2026-02-08

Records

Outreach · Attempt 1 · TCM Accepted

2026-02-08 10:00

Felix Stone

Program Assignment · PCM · Eligible

2026-02-09 14:45

Accepted (assigned by STF-010)

Order Set · Pre-Specialty Urology Bundle · Activated

2026-02-09 14:45

4 orders

Workup Ordered · UA

2026-02-10

Lab

Workup Ordered · PSA

2026-02-10

Lab

Program Assignment · Specialist Referral · Eligible

2026-02-10 14:45

Accepted (assigned by STF-010)

Program Assignment · APCM · Eligible

2026-02-10 14:45

Not accepted (Pass payer check)

Workup Ordered · Renal ultrasound

2026-02-12

Imaging

PCM Enrollment · Enrolled · consent signed

2026-02-13

Workup Scheduled · PSA

2026-02-13

Workup Scheduled · Renal ultrasound

2026-02-14

Billing · PCM Monthly · CPT 99426 · Paid

2026-02-15

$69 / $69

PCM Activity · Care Plan Review · 17m

2026-02-17 13:15

Brandon Lee

Steerage · Imaging → External

2026-02-21

Community Health LA (External)

Workup Completed · Renal ultrasound

2026-02-21

Final

Steerage · Lab → USC

2026-02-22

USC Norris Cancer Hospital

Workup Completed · PSA

2026-02-22

Final

Downstream USC Service · Lab

2026-02-22

Readiness Updated · Score 57% · Blocked

2026-02-22 12:45

1 pending workups; Outside records; PCM enrolment

PCM Activity · Care Plan Review · 10m

2026-02-25 11:15

Brandon Lee

PCM Activity · Phone Call · 22m

2026-02-26 09:15

Brandon Lee

Outreach Attempts

ID	Attempt	Datetime	Outcome	Staff	Min
OUT-0158	#1	2026-01-27 13:15	TCM Accepted	Jamal Carter	8
OUT-0197	#1	2026-02-08 10:00	TCM Accepted	Felix Stone	10

TCM Encounters

No TCM encounter yet

Actionable Chat

Synthetic

I can answer questions about this patient's EPIC workflow, intake trigger, pathway, programs, order set, tasks, and billing evidence. Try one of the suggested prompts below.

Next Best Actions

Rule-based recommendations derived from the patient's current state.

Schedule TCM encounter
High
Patient accepted 70d ago, encounter not yet completed
Owner: NP
Log additional PCM time this month
Medium
Current month at 0m; need 30m more to bill 99426
Owner: RN
Review exception: Pre-Visit Readiness Blocked
Low
Low severity · 65d open
Owner: Ops Coordinator
Route intake trigger
High
Specialty Referral from Independent PCP not yet routed
Owner: Ops Coordinator
Request missing referral documents
High
Referring office has not sent required clinical documents
Owner: Ops Coordinator
Obtain PCM consent
Medium
Patient is PCM-eligible but consent has not been captured
Owner: RN
Schedule lab: Troponin
Medium
Workup ordered but not yet scheduled
Owner: MA
Schedule lab: UA
Medium
Workup ordered but not yet scheduled
Owner: MA
Schedule records: Records request
Medium
Workup ordered but not yet scheduled
Owner: MA
Mitigate leakage risk
High
Referral flagged as at-risk for leaving the USC network
Owner: Ops Coordinator
Close RWE data gaps
Low
4 domain(s) with completeness gaps
Owner: Ops Coordinator

Open Exceptions

Pre-Visit Readiness Blocked
65d open · Open
Low

Longitudinal Episode View

Wilhelmina Xanthopoulos

Episode Timeline

Outreach Attempts

TCM Encounters

Actionable Chat

Chat QA Checklist

Next Best Actions

Open Exceptions