langcare-clinical-summary

name	langcare-clinical-summary
description	Generates a comprehensive clinical summary (CCD-style) from FHIR resources including problems, medications, allergies, labs, vitals, procedures, and immunizations. Use when asked for chart review, clinical summary, patient overview, CCD, or comprehensive patient snapshot before a visit or consult.

Clinical Summary Generator

When to Use This Skill

Use when a clinician needs a consolidated clinical overview of a patient spanning active problems, medications, allergies, recent labs, vitals, procedures, immunizations, and care plans -- analogous to a Continuity of Care Document (CCD).

Clinical Workflow

1. Use fhir_read to retrieve Patient demographics (name, DOB, age, gender, MRN)
2. Use fhir_search to pull active Condition resources for the problem list
3. Use fhir_search to pull active MedicationRequest resources for the medication list
4. Use fhir_search to pull active AllergyIntolerance resources
5. Use fhir_search to pull recent Observation resources (category=laboratory, last 90 days) and vital signs (last encounter)
6. Use fhir_search to pull recent Procedure resources (last 12 months)
7. Use fhir_search to pull Immunization resources
8. Present as structured CCD sections with abnormals flagged

FHIR Resources

• Patient -- Demographics, identifiers
• Condition -- Active problem list with ICD-10/SNOMED codes, onset dates
• MedicationRequest -- Active medications with dose, frequency, route
• AllergyIntolerance -- Allergies with reaction type and severity
• Observation -- Lab results (category=laboratory) and vital signs (category=vital-signs)
• Procedure -- Recent procedures with dates and outcomes
• Immunization -- Vaccination history with dates and vaccine codes
• CarePlan -- Active care plans with goals and activities

FHIR Query Examples

Pull Active Problems

fhir_search(resourceType="Condition", queryParams="patient=[patient-id]&clinical-status=active")

Pull Active Medications

fhir_search(resourceType="MedicationRequest", queryParams="patient=[patient-id]&status=active&_count=100")

Pull Recent Labs (90 days)

fhir_search(resourceType="Observation", queryParams="patient=[patient-id]&category=laboratory&date=ge[90-days-ago]&_sort=-date&_count=200")

Pull Latest Vitals

fhir_search(resourceType="Observation", queryParams="patient=[patient-id]&category=vital-signs&_sort=-date&_count=10")

Clinical Guidelines

• ONC USCDI v3 data classes define the minimum data elements for a clinical summary
• HL7 CDA CCD template defines section structure: Problems, Medications, Allergies, Results, Vitals, Procedures, Immunizations, Plan of Care
• Joint Commission requires medication reconciliation documentation at every transition of care

Interpretation Guide

• Group lab results by panel (CBC, BMP, CMP, lipids) and flag abnormals with reference ranges
• Sort problems by clinical significance: acute conditions first, then chronic active conditions
• For medications, distinguish between chronic maintenance therapy and recent/acute prescriptions by authoredOn date
• Flag overdue preventive care items (e.g., no colonoscopy if age 45+, no mammogram if female 50+)
• Present vitals with trend arrows if multiple readings available

Safety

• Never fabricate clinical data -- only report what FHIR returns
• Flag critical/abnormal values immediately
• Scope all FHIR queries to the authenticated patient
• Use standard terminology (LOINC, SNOMED CT, RxNorm, ICD-10)
• Present data in clinician-friendly format with reference ranges