SYNTHETIC RECORD - Example Redcliff Rheumatology - Follow-up Visit - 2026-08-20
Patient reference SYN-7789. This 33-year-old man was diagnosed with seropositive rheumatoid arthritis at this practice in 2022 after persistent hand and foot swelling with positive serology.
He took oral methotrexate from March 2026 to August 2026, and his synovitis has remained active throughout, an inadequate response despite dose escalation. He works as a landscaper and reports his grip strength has declined, making it harder to use hand tools. He has no other significant medical history.
Immunara is recommended given his sustained disease activity.
Medication history
medication_history
SYNTHETIC RECORD - Example Redcliff Rheumatology - Medication History - 2026-08-15
Patient reference SYN-7789.
METHOTREXATE 20 MG PO WEEKLY - status: inactive - start 2026-03-04 - end 2026-08-11 - reason: inadequate response
FOLIC ACID 1 MG PO DAILY - status: inactive - start 2026-03-04
CETIRIZINE 10 MG PO DAILY - status: active
Insurance card
insurance_card
SYNTHETIC RECORD - ExampleHealth Gold - Member Insurance Card - Issued 2026-01-01
Payer: ExampleHealth
Plan: ExampleHealth Gold
Member ID: EXH-227781
Group Number: EXHG-55019
Member Services: 555-0118
Decisions by provider
AUTO_PROCESS·correct
Decided by: auto_process gate · auto_process 0.89
Judgments
p_yes for yes/no questions; ticks are the thresholds a gate compares each one with.
Diagnosis supported
auto 0.89
0.980
Step therapy met
auto 0.89
0.980
Documentation complete
auto 0.89request info 0.60
0.980
Material contradiction
review 0.80block 0.20
0.060
Missing evidence
NONE 0.970
others: DOSAGE 0.03
Gate path· 7 gates, in engine order
providerpassed
all five decisions present and well-formed
agepassed
patient.age=33, policy min_age=18
contradictionpassed
p_yes(material_contradiction)=0.060, review at >= 0.8
documentationpassed
p_yes(documentation_complete)=0.980, request info below 0.6
missing_evidencepassed
missing_evidence=NONE (p=0.970), request info at >= 0.7
auto_processFIRED → AUTO_PROCESS
min(required p_yes)=0.980, auto at >= 0.89; p_yes(material_contradiction)=0.060, blocks at >= 0.2
default_reviewnot reached
passed = the gate checked and did not fire; not reached = an earlier gate decided.
all required judgments are at or above 0.89 and contradiction risk is below 0.2