Bram Brookfield · Notes · Demo Health Record (demonstration)

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Demo Health Record Riverbend Community Hospital (fictional) synthetic data · demonstration

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Telephone encounter

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Type: Telephone encounter
Date: 2026-10-23 11:20
Author: Mara Ellison, RN
Status: Signed 2026-10-23 11:32

Patient called to confirm the upcoming appointment and to request a refill of atorvastatin. Refill sent to the pharmacy on file per protocol. Advised to bring all medication bottles to the visit.

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Clinician-typed This draft, as declared by the source system

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Agrees Kidney function over time

The note says CKD stage 3b and two results 200 days apart agree (G3b range, filtering rate 37.0 on 2026-04-26 and 34.8 on 2026-11-12).

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Needs a look Blood pressure readings Draft · pending review

Blood pressure 132/78 mmHg on 2026-11-12 10:05 meets the published definition's criteria for the category “stage 1 range (130 to 139 systolic, or 80 to 89 diastolic)” (nhlbi_bp_categories@1.0). The note doesn't mention this.

Another published definition (esc2024_office_bp@1.0) gives the category “office 120 to 139 systolic or 70 to 89 diastolic”.

Published bodies disagree on these thresholds; another definition may give a different answer.

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Published definition and source

High Blood Pressure — Diagnosis
nhlbi_bp_categories@1.0

Normal: Less than 120 systolic AND Less than 80 diastolic; Elevated: 120 to 129 AND Less than 80; Stage 1: 130 to 139 OR 80 to 89; Stage 2: 140 or higher OR 90 or higher; Hypertensive Crisis: Higher than 180 OR Higher than 120

National Heart, Lung, and Blood Institute (U.S. National Institutes of Health) · edition page last updated June 26, 2025 · Blood pressure categories table · opened 2026-11-14 · source

Threshold for this category (nhlbi_bp_categories@1.0): systolic ≥ 130 mmHg and systolic < 140 mmHg or diastolic ≥ 80 mmHg and diastolic < 90 mmHg.

Draft definition: pending clinical and coding review.

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Reason in your words (needed for "Other")

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1 more, grouped by what was measured. At most three are shown above at once.

Cholesterol Not assessable

Not assessable LDL cholesterol Draft · pending review

The note says Hyperlipidemia; it could not be checked against aha2018_severe_hypercholesterolaemia@1.0: there is no LDL cholesterol result in the last 730 days.

Another published definition (atp3_ldl@1.0) cannot decide: there is no usable LDL cholesterol result.

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Published definition and source

2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol
aha2018_severe_hypercholesterolaemia@1.0

Severe Hypercholesterolemia (LDL-C ≥190 mg/dL [≥4.9 mmol/L])

American Heart Association / American College of Cardiology and partner societies · edition 2018 (Circulation 2019;139:e1082-e1143, author manuscript PMC7403606) · Section 4.2 heading; Top 10 Take-Home Message 4 · opened 2026-11-14 · source

Categories that count (aha2018_severe_hypercholesterolaemia@1.0): LDL 190 mg/dL or more (LDL ≥ 190 mg/dL).

Draft definition: pending clinical and coding review.

Details

Thresholds

Kidney function over time: Threshold: filtering rate below 60 on two results at least 90 days apart, none of 60 or more between them.

Rules and published sources

ckd_epi_2009@1.0 Levey et al., Ann Intern Med 2009;150:604-12 (2009 eGFR equation, drift check) · source
ckd_epi_2021@1.0 Inker et al., N Engl J Med 2021;385:1737-49 (2021 race-free eGFR equation) · source
kdigo_aki_2012@1.1 KDIGO 2012 guideline, Kidney Int Suppl 2012;2:1-138 (Rec 2.1.1-2.1.2, Table 2) · source
kdigo_ckd_2024@1.1 KDIGO 2024 guideline, Kidney Int 2024;105(4S):S117-S314 (G/A categories, >3 months) · source
kidney_compare@1.1 Two-sided comparison (this tool); ICD-10-CM guideline I.A.19; ACDIS/AHIMA compliant query practice, 2026 update · source
kidney_exclusions@1.0 KDIGO 2024 guideline, limitations of creatinine-based eGFR (muscle mass, pregnancy, kidney replacement); local list · source
lab_units@1.1 KDIGO 2012 and 2024 guidelines, unit conversion (creatinine 1 mg/dL = 88.4 umol/L; ACR 1 mg/mmol = 8.84 mg/g) · source
nhlbi_bp_categories@1.0 draft, pending review · source
aha2018_severe_hypercholesterolaemia@1.0 draft, pending review · source

Record

Check RUN-00001 · kidney-engine 2.0 · replay 3d4f2d2ebcc5…. Data for this sidebar (JSON).

Library check LRUN-00001 · library_default_set@1.0 · library-engine 1.0 · replay 7e1a90ec93ec….

Decision support only: you decide and you write the note. Exact Dx 1.0.0 · data as of Fri Nov 13, 2026 04:55 PM