SYNTHETIC RECORD - Example Ridgepoint Rheumatology - Progress Note - 2026-05-29
Patient reference SYN-6001.
Subjective: 39-year-old man returns for reassessment of seropositive rheumatoid arthritis, diagnosed in 2021, reporting ongoing bilateral hand and wrist discomfort that limits his grip when lifting boxes at his warehouse job.
Objective: Synovial thickening noted at bilateral wrists and second and third MCP joints. Vitals stable, blood pressure 122/78.
Assessment: Rheumatoid arthritis with persistent synovitis despite a full course of oral methotrexate 15 mg weekly from 2026-03-02 through 2026-05-25, discontinued for inadequate response.
Plan: Switch to Immunara. Continue folic acid. Follow up in six weeks.
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
0.940
Material contradiction
review 0.80block 0.20
0.060
Missing evidence
NONE 0.870
others: TREATMENT_HISTORY 0.11 · DOSAGE 0.02
Gate path· 7 gates, in engine order
providerpassed
all five decisions present and well-formed
agepassed
patient.age=39, policy min_age=18
contradictionpassed
p_yes(material_contradiction)=0.060, review at >= 0.8
documentationpassed
p_yes(documentation_complete)=0.940, request info below 0.6
missing_evidencepassed
missing_evidence=NONE (p=0.870), request info at >= 0.7
auto_processFIRED → AUTO_PROCESS
min(required p_yes)=0.940, 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