Langcare Vte Risk

FHIR Resources

• Patient -- Age, gender
• Condition -- Cancer, prior VTE, thrombophilia, HF, stroke, acute infection
• Observation -- Heart rate, SpO2, D-dimer, hemoglobin
• Procedure -- Recent surgery type and date
• Encounter -- Admission context, immobilization
• MedicationRequest -- Current anticoagulation, hormonal therapy, chemotherapy

FHIR Query Examples

Pull Risk Factor Conditions

fhir_search(resourceType="Condition", queryParams="patient=[patient-id]&clinical-status=active")

Pull D-dimer

fhir_search(resourceType="Observation", queryParams="patient=[patient-id]&code=48066-5&_sort=-date&_count=1")

Clinical Guidelines

• ACCP (CHEST) Guidelines for VTE Prevention in Hospitalized Patients
• ASH 2019 VTE Guidelines
• Caprini Risk Assessment Model for surgical patients
• Padua Prediction Score for medical patients

Interpretation Guide

• Wells DVT: <=0 low probability (D-dimer to rule out), 1-2 moderate, >=3 high (ultrasound)
• Wells PE: <=4 PE unlikely (D-dimer), >4 PE likely (CTPA)
• Caprini: 0-1 very low (early ambulation), 2 low (consider prophylaxis), 3-4 moderate (prophylaxis recommended), >=5 high (prophylaxis + mechanical)
• Padua: <4 low risk (no pharmacologic prophylaxis), >=4 high risk (anticoagulant prophylaxis)

Safety

• Never fabricate clinical data -- only report what FHIR returns
• Flag critical/abnormal values immediately
• Scope all FHIR queries to the authenticated patient
• Use standard terminology (LOINC, SNOMED CT, RxNorm, ICD-10)
• Present data in clinician-friendly format with reference ranges