lookup-patient-history

Lookup Patient History

Read data/patients/{patient_id}.json relative to the workspace root and inline its referenced prior reports. Return data, not a clinical interpretation.

Scope and handoff

• File reads and file searches are permitted. Do not call segmentation or measurement tools during this lookup step. This restriction ends when the lookup returns; the parent report workflow must then perform its measurement steps.
• When used by a report skill, return the record internally and resume the parent workflow. Do not treat this helper's completion as the final chat response.
• When explicitly requested on its own, return only the patient-record block.
• Keep the block concise, but preserve all study dates, paths, treatment and procedure details, LAST RECORD ENTRY NOTE, and full prior report text. Do not truncate these to meet a word budget.

How to use

1. Resolve the identifiers.
   • Use a supplied patient_id; otherwise infer it by removing .nii.gz and the trailing _NNN from the filename, for example SYN0056_006.nii.gz gives SYN0056.
   • Retain the current study_id to identify the matching pending order. If the filename does not identify the patient or study and the caller has not supplied it, request clarification rather than guessing.
2. Read the chart.
   • Read data/patients/{patient_id}.json.
   • If the file does not exist, return PATIENT RECORD: Not on file for patient_id {patient_id}. to the parent, which must still measure the current image. This ends only the lookup.
   • If the file exists but cannot be read or parsed, report the specific error and stop the workflow; do not mislabel it as a missing chart.
3. Inline prior reports.
   • For each non-null report_path in imaging_studies, read the report and include its full text verbatim.
   • Resolve paths from the workspace root. If a report is not there, look for the same filename in the neighboring reports directory; do not substitute a different study.
   • If a report remains missing, include [report file missing: {path}] and continue with the other chart data. The parent must disclose that missing source.
4. Return the block below, preserving the section headers. Mark the pending order that matches the current study.

Output format

PATIENT RECORD - {patient_id}, as of {record_as_of}

DEMOGRAPHICS: {demographics.age}{demographics.sex}.

DIAGNOSIS: {diagnosis.primary} {diagnosis.molecular} Established {diagnosis.established}

PRESENTATION: {presentation.date}. {presentation.presenting_complaint}
HPI: {presentation.hpi_summary}

ACTIVE PROBLEMS:
- {each item from active_problems}

PAST MEDICAL HISTORY:
- {each item from past_medical_history}

ALLERGIES: {allergies.notes}

CURRENT MEDICATIONS:
- {name} {dose} - {indication}
  (one line per item from medications)

PROCEDURES:
- {date}: {procedure}. {result} Complications: {complications}
  (one line per item from procedures)

TREATMENTS:
- {start} -> {end, or "ongoing" if null}: {treatment}. {notes}
  (one line per item from treatments)

EXPECTED POST-TREATMENT FINDINGS (per record):
- {each item from expected_post_treatment_findings}

IMAGING HISTORY (oldest to newest):
- {study_id} - {date}, {exam}. {summary} Image: {image_path, or "not retained"}
  (one line per imaging_studies entry)

PRIOR REPORTS:
=== {study_id} ({date}) ===
{full report text loaded from report_path, or the missing-file notice}
===
  (one block per imaging_studies entry with a report_path)

PENDING ORDERS:
- {study_id} - {date}, {exam}. Indication: {indication} Status: {status}
  (one line per pending_orders entry; mark the matching study with "<- current image")

LAST RECORD ENTRY NOTE: {last_record_entry_note}

Critical rules

• Do not invent fields. Render missing, empty, or null fields as (none) unless the format specifies otherwise.
• Do not summarize the prior report or substitute its measurements for a current image measurement.
• Do not interpret findings or decide which lesion is new. The parent report skill combines the record with imaging evidence.
• Always include LAST RECORD ENTRY NOTE so the report writer knows where the record ends.