Evidence Explorer

24 decisions · 23 governed
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Member M-5541
Scoped to your caseload — 47 members
Source System
Document Type
Date Range
Member: M-5541
Trace ID
5 sources found
Discharge Summary — Valley Medical Center
Hospital ADT FeedReceived: 6 Aug 2026
CHF exacerbation, follow-up orders
Pharmacy Claims — furosemide, lisinopril
Pharmacy SystemAs of: 9 Aug
Used in: 2 traces
Discharge fills not yet claimed
Provider Directory — Dr. Nakamura, cardiology
Provider Network
Used in: 1 trace
In-network status, availability
Member Contact Log
CRM / Outreach2 attempts documented
Used in: 1 trace
Voicemail 7 Aug, SMS 8 Aug
Readmission Risk Score — M-5541
Enterprise Brain outputCalculated: 7 Aug
Used in: 1 trace
34% — high; CMS-adapted methodology

Discharge Summary — Valley Medical Center

Source: Hospital ADT Feed · Received: 6 Aug 2026
Used by 2 Brain operations
Inpatient Discharge Summary
M-5541 · DC 6 Aug 2026
Member M-5541 · 71F · Valley Medical Center · Attending: Dr. L. Okonkwo, MD
Encounter
Admitted2 Aug 2026 Discharged6 Aug 2026 Primary DxAcute on chronic CHF exacerbation (I50.23) DispositionHome with home-health referral
Follow-Up Orders
PCP follow-up within 7 days of discharge; cardiology (Dr. Nakamura) within 14 days; home-health RN visit within 48 hours.
Used in EB-HP-02356, Step 2
Medication Changes
Increase furosemide to 40 mg daily; continue lisinopril 10 mg; add metoprolol succinate 25 mg daily. Reconcile prior fills at first outreach.
Used in EB-HP-02356, Steps 2–3
Member counseled on daily weights and low-sodium diet. Discharge instructions transmitted to health plan care team via ADT feed for transition coordination.
How This Evidence Connects
generate 4 care gaps
checked against Pharmacy claims (unfilled)
drives Outreach actions in EB-HP-02356