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Pre-consult briefing → live 4-pane consult with AI co-pilot + Clinical Integrity Engine → post-consult SOAP with override log. 1440w target.

① Pre-consult AI briefing opens T-3min
doctor.averra.ae / patient / SA-4821 / briefing
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Status
● Available
NABIDH ●
AI models ●
b.2026.04.18
Pre-consult brief · Sara A.
RescheduleAdmit →
Patient
SA
Sara Al Ameri
F · 31 · EID ···4821
◆ Plus
Allergies
⚠ Penicillin — rash
Active problems
Prediabetes · E11.9 Dyslipidemia · E78.5
Language · Gender pref.
Arabic / English · female GP preferred
Family context
Manager · 2 dependants
Consent scope (this visit)
Tier 2 Full EHF · 24h · revocable
AI briefing
Med42 · MedGemma · 91%
AI-drafted — verify before use
Why they're here
Sara booked a 15-min review after her HbA1c moved from 5.8 → 5.6%. Question: can she stop metformin? source: Ask thread · Apr 19
What's changed since last visit
Lost 3.2 kg over 90 days (self-reported + smart scale). Daily step median 9,400 (vs 5,200 baseline). BP home-log stable 118/76.
Recent labs · 14 Apr
HbA1c 5.6 %
ApoB 98 mg/dL
LDL-C 112
HDL-C 58
ALT 22
eGFR 94
Meds (active)
Metformin 500mg BID · Rosuvastatin 10mg QD
1 possible DDI (mild) — CYP3A4
Mention this?
  • Suggest continued metformin (ADA: maintain through prediabetes resolution for durability).
  • Confirm statin adherence — ApoB borderline.
  • Screen for NAFLD given prior ALT trend.
Twin · clinician
Lipids Glu BP Inflam Liver Renal Thyr BC
Risk per system
Cardio ○ low
Metab. ◐ mod
Renal ○ low
Hepatic ○ low
Predictive alerts (12mo)
↑ NAFLD risk band at current trajectory — confidence 64%
↳ Opens automatically at T-3min. Every AI paragraph has evidence chips; doctor can edit any block before admitting.
↳ Left column masks EID; reveal is audit-logged.
Consent scope chip explicit on the screen where data is used.
② Live consultation · 4 panes CIE + CDS
doctor.averra.ae / consult / live · ●REC · 00:14:32
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In call
Sara A.
● connected 94%
patient video feed
self
🎙
📹
💬
Co-pilot
3 cards
infoMed42 · 84%
Differential · dyspepsia on metformin
GI upset (metformin) · 62%
H. pylori · 18%
Functional · 12%
Why? · NICE NG28
⚠ warningAverra CIE · NICE NG59
Consider non-imaging for acute low-back pain
Ordered MRI lumbar is outside guideline for <6wk symptoms without red-flags.
Order X-ray Physio referral Proceed with reason…
⚠ DDIRxNorm
Rosuvastatin + grapefruit (self-reported) — mild
Ask why? · 72%
Transcription
● live · EN
Dr. How has the dyspepsia been since we changed the dose?
Sara Better in the morning, still bloated after lunch.
Dr. Any black stools, weight loss, night pain?
Sara No.
+ INSERT TO SOAP Dr. Plan: H.pylori stool antigen; review in 4 weeks.
SOAP · draft
auto-saved 12s ago
S O A P
Subjective
31 F with prediabetes presents for 15-min review. HbA1c improved 5.8→5.6%. Reports metformin-related dyspepsia; mild, post-prandial. Denies red flags. Asks re: discontinuing metformin.
confidence high
shortcuts: ⌘1-4 SOAP · ⌘D insert DDx · ⌘⇧O order · ⌘⇧R prescribe · ⌘. dismiss card
CIE card is advisory — never blocks the order. "Proceed with reason" requires category + free-text which logs to override audit.
↳ Max 3 cards visible; others collapse to "More (n)".
↳ Drag a transcription line onto SOAP → inserted with provenance.
③ Post-consult SOAP · sign & submit
doctor.averra.ae / consult / note / SA-4821-20260420
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Note · Sara A. · 20 Apr 2026
Duration 14:32 · Mode teleconsult · Lang EN
S · Subjective
AI conf. high
31F, prediabetes E11.9. Reports mild post-prandial dyspepsia on metformin. HbA1c improved 5.8→5.6%. No red flags.
O · Objective
BP 118/76 · HR 68 · BMI 23.1. Labs 14 Apr: HbA1c 5.6%, ApoB 98, ALT 22, eGFR 94.
A · Assessment
1. Prediabetes — improving · ICD-10 E11.9 SNOMED 43959009
2. Dyspepsia, drug-induced · K30
P · Plan
— Continue metformin 500mg BID with food (ADA 10.4.2 met)
— Order H. pylori stool antigen LOINC 58030-3
— Physio referral — lumbar
— Review 4 weeks
Override log · 1 entry
CIE · MRI lumbar outside guideline — dismissed.
Reason: clinical judgment · prior worsening neurological signs · category 3 of 8
logged 20 Apr 14:28 GST · auditable
Orders
✓ Rx · Metformin 500mg BID × 90d
✓ Lab · H.pylori stool ag
✓ Referral · Physio · Dr. L. Fonseca
DDI: none new · verified
Quality
Guideline adherence · 88%
Time-to-note · 2m 14s
ADA 10.4.2 met NG28
Sign & submit
Emits FHIR Bundle · sends member summary & care plan · NABIDH sync.
Biometric Sign · PIN
↳ ICD-10 requires explicit accept (regulatory).
↳ Override log pinned to note — never hidden. Reason category (1 of 8) + free text.
↳ Sign = biometric or PIN; timestamped; FHIR Bundle emitted.
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