Marta Ruiz Delgado
AT RISK · 33/100 Ref: SYN-0001 · 68y FemaleScheduled for tomorrow at 14:30 · New Cardiology Consultation
33/100
Readiness Score
7
Identified Gaps
📄 Source Evidence & Textract Confidence Gate
1 Smudged Token Discarded (<60%)
TRANSCRIPT: doc2 (Handwritten Medication List)
Gate Filtered
[L03] 1. Ramipril 5mg — morning
99.2% Conf High
[L04] 2. Atorvastatin 40mg — at night
98.8% Conf High
[L05] 3. Apixaban ⟪ILLEGIBLE⟫ twice a day
43.08% UNREADABLE
🛡 Textract Confidence Gate: Token read as "9" with 43.08% confidence. Below 60% floor → Text discarded before Bedrock sees it. Guessing prevented.
[L06] 4. Metformin 19⟨?⟩ twice a day
72.5% Conf Low
[L07] 5. Bísoprolol 2.5mg — morning
99.6% Conf High
⚡ Cross-Document Reconciliation Finding (doc3 vs doc2):
Discharge summary photo states: "Apixaban continued. Dose reduced on discharge - see TTO." Medication chart dose is smudged. Two independent sources checked — dose unknown.
🩺 Consulting Doctor: 30-Second Pre-Visit Brief
Zero Trust Enforced
Headline Narrative
68-year-old female with intermittent palpitations and light-headedness. Background of hypertension, type 2 diabetes, and paroxysmal atrial fibrillation on anticoagulation.
Active Medications (Verified Only)
Apixaban — DOSE NOT DOCUMENTED (High Risk)
⚠️ Escalated to Nurse
Ramipril — 5mg once daily
Atorvastatin — 40mg at night
Bísoprolol — 2.5mg morning
Metformin — DOSE NOT DOCUMENTED (illegible in source)
⚠️ Consultation Blocked — 2 Critical Items Missing:
- Referral Question: GP letter is a courtesy ("grateful for your opinion"), not a specific clinical question.
- Anticoagulant Dose: Changed on discharge; current dose unconfirmed across 2 sources.
Morning Phone Call Queue (2 Calls)
CALL 1 · REFERRING GP (Dr Okafor)
BLOCKING GAP
Target: Riverside Family Practice · Tel: 0141 555 0182
☎ "Hello, calling from cardiology about a referral for Marta Ruiz Delgado. The letter describes her history but does not specify what you would like us to advise on. Could you confirm the specific referral question?"
CALL 2 · PATIENT (Marta Ruiz Delgado)
IMPORTANT GAP
☎ "Hello Marta, calling from the clinic before your appointment. Can I check whether you have any drug allergies, and what happens when you take them?"
CLINICAL RECONCILIATION DISCREPANCY
HIGH RISK
Unreconciled Medication Change: Apixaban (Anticoagulant)
Document 3 asserts: "Apixaban continued. Dose reduced on discharge - see TTO." Document 2 handwritten dose is smudged. Two independent sources checked — current dose is unknown.
Action Required: Confirm current dose against community dispensing pharmacy or hospital discharge prescription before consultation proceeds.
Zero-Trust Access Audit Log
✔ 14:38:12 · doctor.zayed · apt-001 brief read · ALLOWED
✔ 14:38:15 · nurse.sarah · apt-001 reconciliation read · ALLOWED
⛔ 14:38:22 · reception.anna · apt-001 brief read · REJECTED (AccessDenied)
⛔ 14:38:40 · doctor.other_practice · apt-001 · REJECTED (Cross-Practice Violation)
BENCHMARK (20 BEDROCK RUNS):
✔ 20/20 Dose Guesses Refused (100%)
✔ 20/20 Reconciliations Detected (100%)
✔ 20/20 AT RISK Status Stable (100%)
✔ 19/20 Score 33/100 (95% Determinism)
Bedrock: Amazon Nova Pro · Strands SDK