Margaret Chen

68 F · DOB 1957-03-14 · MRN DEMO-1001

ALLERGY · Sulfa drugs (rash)ALLERGY · ShellfishFall RiskAnticoagulated

Primary providerDr. Amanda Reyes, MD

NurseBrandon S., RN

Last visit2026-04-15

Active problems

·Chronic systolic heart failure (EF 35%)I50.22
·Atrial fibrillation, persistentI48.1
·Hypertension, essentialI10
·Type 2 diabetes mellitusE11.9
·Chronic kidney disease, Stage 3aN18.31

Recent labs

INR

1.8

2026-04-22 · LOW

BNP

612

2026-04-15 · HIGH

Creatinine

1.4

2026-04-15 · HIGH

Potassium

4.2

2026-04-15 · NORMAL

HbA1c

7.2

2026-03-01 · HIGH

Risk scores

Hf Readmission30Day

Bleeding Risk

Adherence Estimate

Guideline Concordance

Guideline gaps

Not on SGLT2 inhibitor
HFrEF + T2DM + adequate eGFR. Class 1a recommendation per 2022 AHA/ACC HF Guidelines.
priority · high
Not on ARNI despite HFrEF
EF 35% on lisinopril. Guideline recommends transition to sacubitril/valsartan if tolerated.
priority · medium

AI Insights

Last analysis: 14 seconds ago

Multi-signal HF decompensation pattern emerging

Weight up 5 lbs (158→164), BNP doubled since February (445→612), 2 MyChart messages reporting persistent DOE despite added PRN furosemide. Pattern matches early decompensation prodrome.

Confidence: High

›Why did Kairos say this?

Data sources consulted

·Weights 2026-02-25 → 2026-04-15 (vitals)
·BNP 2026-02-10 (445) and 2026-04-15 (612)
·MyChart messages 2026-04-18 and 2026-04-20
·Visit note 2026-04-15: bibasilar crackles, 1+ ankle edema

Rules applied

·HF decompensation prodrome
·BNP trend doubling
·MyChart symptom escalation

Output validated by

·Lab-trend post-processor
·Symptom-message classifier

Confidence reasoning

Three concordant signals (weight, BNP, symptoms) within a 10-day window. Specificity high; prior-pattern match documented.

Warfarin subtherapeutic ×3 despite dose increase

INR 1.7 → 1.9 → 1.8 over 4 weeks despite ~7% dose increase. Consider dietary vitamin K shift, adherence review, or larger (10-15%) titration.

Confidence: High

›Why did Kairos say this?

Data sources consulted

·INR 2026-03-25, 2026-04-08, 2026-04-22

Rules applied

·Subtherapeutic INR streak detector

Output validated by

·Anticoag dose-response post-processor

Confidence reasoning

Three consecutive subtherapeutic INR results with documented dose change.

GDMT gap: SGLT2 + ARNI not on board

HFrEF (EF 35%) + T2DM + adequate eGFR meets Class 1a criteria for SGLT2 inhibitor per 2022 AHA/ACC. Currently on lisinopril rather than ARNI.

Confidence: High

›Why did Kairos say this?

Data sources consulted

·Problem list (HFrEF, T2DM, CKD-3a)
·Medication list
·Most recent eGFR

Rules applied

·HFrEF GDMT: SGLT2 indicated
·HFrEF GDMT: ARNI preferred over ACE-I

Output validated by

·Guideline-gap engine 2022 AHA/ACC HF

Confidence reasoning

Deterministic rule match against current medication list.