Patient 360
Longitudinal Episode View
Search a synthetic patient or episode to inspect discharge → TCM → PCM → billing → outcomes end-to-end.
Patricia Evans
PT-000005 · USC-900005 · EPI-2026-0005
NBA: Verify DME delivery + patient education
Reason codes: AGE>=65, PRIOR_COMPLICATION, PAYER_PCM_ELIGIBLE
Outreach
4
PCM Min.
0
Paid $
$0
Age / Sex
72 · F
ZIP
90027
Language
English
Payer
Medicare FFS
Procedure
TURP
Surgeon
Dr. Rebecca Lim
Surgery Site
Keck Hospital of USC
Surgery Date
Mar 22, 2026
Discharge
Mar 25, 2026
LOS
3d
Status
Outreach
Consent
On file
Episode Timeline
18 eventsIntake Trigger · Surgery Schedule · USC Surgical Scheduling System
2026-03-11 17:00Routed at 2026-03-11 00:00
AI Detection · AI score 75%
2026-03-11 17:00AGE>=65, PRIOR_COMPLICATION, PAYER_PCM_ELIGIBLE
Program Assignment · TCM · Eligible
2026-03-12 00:00Accepted (assigned by AI Engine)
Program Assignment · DME · Eligible
2026-03-12 00:00Accepted (assigned by AI Engine)
Program Assignment · Post-Acute · Eligible
2026-03-12 00:00Accepted (assigned by AI Engine)
Order Set · Post-Urology Discharge Bundle · Activated
2026-03-12 00:004 orders
Workflow Task · Initiate DME · Done
2026-03-21 00:00DME · Ops Coordinator
Surgery · TURP
2026-03-22Dr. Rebecca Lim
DME Order · Pacific DME (mock) · 2 item(s) · Delivered
2026-03-24 00:00A4338 Foley catheter, 2-way, 30d supply · E0114 Crutches, underarm, pair
Discharge · LOS 3d
2026-03-25Outreach · Attempt 1 · TCM Accepted
2026-03-25 17:45Felix Stone
Outreach · Attempt 2 · No Answer
2026-03-27 15:00Jamal Carter
Outreach · Attempt 3 · TCM Declined
2026-03-29 15:00Felix Stone
DME Fulfillment · Delivered via Local Courier
2026-03-30Patient education complete
Outreach · Attempt 4 · No Answer
2026-03-31 12:00Jamal Carter
TCM Encounter · Telehealth · CPT 99495
2026-04-05Note sent to USC
Steerage · Follow-up → USC
2026-04-13Keck Hospital of USC
Exception · TCM Not Scheduled · High · Open
2026-04-28 13:00Sofia Diaz
Outreach Attempts
| ID | Attempt | Datetime | Outcome | Staff | Min |
|---|---|---|---|---|---|
| OUT-0010 | #1 | 2026-03-25 17:45 | TCM Accepted | Felix Stone | 3 |
| OUT-0011 | #2 | 2026-03-27 15:00 | No Answer | Jamal Carter | 4 |
| OUT-0012 | #3 | 2026-03-29 15:00 | TCM Declined | Felix Stone | 11 |
| OUT-0013 | #4 | 2026-03-31 12:00 | No Answer | Jamal Carter | 4 |
TCM Encounters
| ID | Encounter | Type | CPT | Doc Complete | Note → USC | Staff |
|---|---|---|---|---|---|---|
| TCM-0032 | 2026-04-05 | Telehealth | 99495 | Yes | Yes | Jamal Carter |
Actionable Chat
SyntheticNext Best Actions
Rule-based recommendations derived from the patient's current state.
Resolve exception: TCM Not Scheduled
CriticalOpen 0d, assigned to Sofia Diaz
Owner: RN
Offer PCM enrollment
MediumTCM completed; patient not yet enrolled in PCM
Owner: NP
Backfill PROMs RWE
LowPROMs only 42% complete
Owner: Ops Coordinator
Open Exceptions
- High
TCM Not Scheduled
0d open · Open