ingest-medical-record

name	ingest-medical-record
description	Ingest a medical document (visit summary, EOB, lab result, prescription note) into a `medical-record` capture page in `wiki/library/`, append a dated entry to the patient's case overview under `wiki/efforts/cases/`, and update the patient's medications page and providers. Load from the `ingest` skill when content-type routing identifies the source as medical (clinic or insurer letterhead, EOB layout, lab-result format). Pairs with the `medical-summary` operation (visit prep) and `follow-up-tracker` (recheck reminders).
license	MIT

ingest-medical-record

Capture a medical document and append it to the household's record in a way the medical-summary and follow-up-tracker operations can use.

When you're loaded

The ingest skill routes here when:

• A medical PDF or photo is dropped (visit summary, EOB, lab result, prescription note).
• A patient-portal screenshot or PDF is provided.
• A summary from a visit is pasted.
• The user says "ingest this medical record" or "save this visit".

If the patient isn't obvious from the document, ask before assigning. A misfiled medical record is much worse than a slow ingest.

Inputs you'll see

• A cleaned-up medical document (the ingest skill runs source-type cleanup first — Docling for PDFs and photos, paste handling for text).
• The person whose record this is — confirm against wiki/people/.

You need to extract:

• medical_record_person — the patient's canonical name as it appears in wiki/people/. If no person page exists, stub one.
• medical_record_date — the date of service (not today). EOBs sometimes span multiple visits; if so, ask the user to pick one.
• medical_record_provider — the provider name and (where known) the practice. Stub the provider as a vendor node (genre: profile, subtype: vendor) in wiki/people/ if new.
• medical_record_kind — short label: visit-summary, eob, lab-result, prescription, vaccination, etc.

Page shape

Render from _templates/medical-record.md. The record is a capture page in wiki/library/, filename wiki/library/YYYY-MM-DD-{person-slug}-{kind}.md (e.g. 2026-04-15-jake-doe-visit-summary.md), with parent: pointing at the patient's case folder under wiki/efforts/cases/ (a bounded medical episode — stub the case folder + overview on first reference). Then also append a dated entry to the case overview page (reverse- chronological — newest at the top) so the summary skill has one place to read from.

Side-effects

• Medications. If the document mentions a new prescription, a dose change, or a discontinuation, update the patient's medications reference page in wiki/library/ ({person-slug}-medications.md). Surface the change before writing; do not silently overwrite an existing medication entry that conflicts. Use a > [!danger] Contradiction callout on a conflict.
• Providers. Stub new providers as vendor nodes (genre: profile, subtype: vendor) in wiki/people/ with their name, practice, phone, and the date you first saw them.
• Follow-ups. Every recheck or next-visit note becomes a callout on the case overview page:

  > [!important] Follow-up due by 2026-10-15
  > Allergy panel recheck (Dr. Chen, Riverdale Pediatrics).
  

  The follow-up-tracker operation scans for these.

Sensitive data

Medical documents often include SSNs, account numbers, and member IDs. Never propagate any of these into a wiki page. Redact them on the way in; the raw PDF stays in raw/medical/ (which should be on the gitignored side of the vault). If you find that a value slipped through into the page text, surface it and stop before writing.

When you can't extract cleanly

• OCR garbled. Surface the extracted text; ask the user to confirm date, provider, diagnoses, and prescriptions before writing.
• Patient ambiguous. Multiple family members are plausible — ask.
• Conflicting prescription data. Surface as a contradiction; let the user reconcile.
• No clear date of service. Ask the user.

After writing

• Append a one-line entry to the wiki's running activity.
• If the person hasn't had a medical-summary produced in the last six months, mention that one is due — wiki run medical-summary reads exactly what you just wrote.