Care coordination and data sharing
Granted
Date: 2 December 2025
Method: Recorded at enrolment (fictional)
Care team demo
Back to patients
Jonas Demo-Keller
68 years · Male
- ID
- DEMO-784-0027
- Insurance plan
- Enhanced (fictional)
- Family physician
- Dr Demo-Okafor
- Consent status
- Consent recorded
- Preferred language
- English
- Phone
- +971 50 000 0027
Priority 1 · urgent
Why this priority
One abnormal result: BP 154/92 mmHg; age 68 adds one level; 108 days since result; lost to follow-up.
Urgent, within 7 days.
Drop-off risk: Medium
Estimate to help prioritise – not a judgement of the person.
- 108 days waiting.
Consent
Consent records
Each purpose is recorded on its own. If reminder consent is withdrawn, no new reminders are created.
Reminders by chosen channel
Granted
Date: 2 December 2025
Method: Recorded at enrolment (fictional)
De-identified programme statistics
Granted
Date: 2 December 2025
Method: Recorded at enrolment (fictional)
2 December 2025
Blood pressure
Abnormal154/92 mmHg
2 December 2025
Lost to follow-upOwner: Dr Demo-OkaforLost to follow-upFacility: Not recorded
Entered by: Not recorded
Next step: Lost to follow-up
AI suggestion – clinician decides
Refer to cardiology/internal medicine clinic
- BP 154/92 mmHg is abnormal.
This is not a diagnosis or a prescription.
Accepted by Dr Demo-Okafor – 2 December 2025
Next step now: Refer to cardiology/internal medicine clinic
Essential hypertension
- ICD-11
- BA00
- ICD-10-CM
- I10
Suggested code – coder/clinician to confirm
Look up codes in SmartMedCodeOutcome tracking
Care received, the first assessment, and who verified it. This does not diagnose or prescribe.
Lost to follow-up: the stage is already lost, or there are 3 unanswered reminders and the case is 30 days overdue.
Days from result to assessment: Not calculated yet
Choose a treatment or management step, then mark Attended and verified.
Close case
Only the Family Physician or Programme Manager can close a case.
2 December 2025
FIT stool test
AbnormalPositive
2 December 2025
Care completed and verifiedFacility: Not recorded
Entered by: Not recorded
Next step: Care completed and verified
AI suggestion – clinician decides
Refer for colonoscopy
- A positive FIT means the stool screen found blood.
This is not a diagnosis or a prescription.
Accepted by Dr Demo-Okafor – 2 December 2025
Next step now: Refer for colonoscopy
Positive FIT (occult blood in stool)
- ICD-11
- Mapping not configured in this demo
- ICD-10-CM
- R19.5
Suggested code – coder/clinician to confirm
Look up codes in SmartMedCodeOutcome tracking
Care received, the first assessment, and who verified it. This does not diagnose or prescribe.
Days from result to assessment: Not calculated yet
This case is already Care completed and verified.
Close case
Only the Family Physician or Programme Manager can close a case.