abridge-core-workflow-b

Abridge Core Workflow B — Patient-Facing Documentation

Overview

Secondary workflow: generating plain-language patient summaries from the same clinical encounter captured in Workflow A. Abridge produces both clinician notes and patient-friendly after-visit summaries (AVS), supporting 28+ languages and multiple reading levels.

Prerequisites

• Completed abridge-core-workflow-a (encounter-to-note pipeline)
• Patient portal integration configured (Epic MyChart, Athena Patient Portal)
• Understanding of health literacy requirements

Instructions

Step 1: Request Patient Summary from Completed Session

// src/workflows/patient-summary.ts
import axios, { AxiosInstance } from 'axios';

interface PatientSummary {
  summary_id: string;
  session_id: string;
  language: string;                    // ISO 639-1 code
  reading_level: 'basic' | 'intermediate' | 'advanced';
  sections: {
    visit_reason: string;              // Plain-language chief complaint
    what_we_discussed: string;         // Key discussion points
    your_diagnosis: string;            // Explained at target reading level
    next_steps: string;                // Action items for patient
    medications: Array<{
      name: string;
      instructions: string;           // "Take 1 pill by mouth twice daily"
      warnings: string;
    }>;
    follow_up: {
      when: string;                    // "Come back in 2 weeks"
      why: string;                     // "To check if your cough improved"
      scheduling_instructions: string;
    };
    questions_to_ask: string[];        // AI-suggested questions for next visit
  };
  source_encounter: {
    date: string;
    provider_name: string;
    department: string;
  };
}

async function generatePatientSummary(
  api: AxiosInstance,
  sessionId: string,
  language: string = 'en',
  readingLevel: PatientSummary['reading_level'] = 'basic'
): Promise<PatientSummary> {
  const { data } = await api.post(`/encounters/sessions/${sessionId}/patient-summary`, {
    language,
    reading_level: readingLevel,
    include_medications: true,
    include_follow_up: true,
    include_suggested_questions: true,
  });

  return data;
}

Step 2: Push to Patient Portal via FHIR

// src/workflows/patient-portal-push.ts
interface FhirCommunication {
  resourceType: 'Communication';
  status: 'completed';
  category: Array<{ coding: Array<{ system: string; code: string }> }>;
  subject: { reference: string };
  encounter: { reference: string };
  payload: Array<{ contentString: string }>;
  sent: string;
}

async function pushToMyChart(
  fhirBaseUrl: string,
  accessToken: string,
  summary: {
    patient_id: string;
    encounter_id: string;
    content: string;
    language: string;
  }
): Promise<string> {
  const communication: FhirCommunication = {
    resourceType: 'Communication',
    status: 'completed',
    category: [{
      coding: [{
        system: 'http://terminology.hl7.org/CodeSystem/communication-category',
        code: 'notification',
      }],
    }],
    subject: { reference: `Patient/${summary.patient_id}` },
    encounter: { reference: `Encounter/${summary.encounter_id}` },
    payload: [{ contentString: summary.content }],
    sent: new Date().toISOString(),
  };

  const response = await axios.post(
    `${fhirBaseUrl}/Communication`,
    communication,
    { headers: { Authorization: `Bearer ${accessToken}` } }
  );

  return response.data.id;
}

Step 3: Multi-Language Translation

// src/workflows/translation.ts
// Abridge supports 28+ languages natively — no external translation service needed

const SUPPORTED_LANGUAGES = [
  'en', 'es', 'zh', 'ar', 'vi', 'ko', 'tl', 'ru', 'fr', 'pt',
  'hi', 'de', 'ja', 'it', 'pl', 'ur', 'fa', 'bn', 'pa', 'gu',
  'ha', 'yo', 'am', 'so', 'sw', 'ne', 'my', 'th',
] as const;

async function generateMultiLanguageSummaries(
  api: AxiosInstance,
  sessionId: string,
  languages: string[]
): Promise<Map<string, PatientSummary>> {
  const summaries = new Map<string, PatientSummary>();

  // Generate summaries in parallel for requested languages
  const results = await Promise.allSettled(
    languages.map(lang =>
      generatePatientSummary(api, sessionId, lang, 'basic')
    )
  );

  results.forEach((result, index) => {
    if (result.status === 'fulfilled') {
      summaries.set(languages[index], result.value);
    } else {
      console.error(`Translation failed for ${languages[index]}:`, result.reason);
    }
  });

  return summaries;
}

Step 4: Format After-Visit Summary (AVS)

// src/workflows/avs-formatter.ts
function formatAfterVisitSummary(summary: PatientSummary): string {
  const lines: string[] = [
    `AFTER-VISIT SUMMARY`,
    `Date: ${summary.source_encounter.date}`,
    `Provider: ${summary.source_encounter.provider_name}`,
    `Department: ${summary.source_encounter.department}`,
    '',
    `WHY YOU CAME IN`,
    summary.sections.visit_reason,
    '',
    `WHAT WE DISCUSSED`,
    summary.sections.what_we_discussed,
    '',
    `YOUR DIAGNOSIS`,
    summary.sections.your_diagnosis,
    '',
    `WHAT TO DO NEXT`,
    summary.sections.next_steps,
  ];

  if (summary.sections.medications.length > 0) {
    lines.push('', 'YOUR MEDICATIONS');
    for (const med of summary.sections.medications) {
      lines.push(`  ${med.name}: ${med.instructions}`);
      if (med.warnings) lines.push(`    Important: ${med.warnings}`);
    }
  }

  lines.push(
    '',
    'FOLLOW-UP',
    `When: ${summary.sections.follow_up.when}`,
    `Why: ${summary.sections.follow_up.why}`,
    summary.sections.follow_up.scheduling_instructions,
  );

  return lines.join('\n');
}

Output

• Patient-friendly after-visit summary at target reading level
• Multi-language translations (28+ languages supported)
• FHIR Communication resource pushed to patient portal
• Formatted AVS document with medications, follow-up, and next steps

Error Handling

Error	Cause	Solution
Unsupported language	Language not in Abridge's 28+ set	Check SUPPORTED_LANGUAGES list
Summary too vague	Encounter transcript was short	Ensure encounter has enough clinical detail
MyChart push 403	Patient portal not linked	Verify patient has active MyChart account
Missing medications	Provider didn't discuss meds	Medications only included if mentioned in encounter

Resources

• Abridge Platform
• FHIR R4 Communication Resource
• Health Literacy Guidelines (CDC)
• Epic MyChart Integration

Next Steps

For common integration errors, see abridge-common-errors.