Epic Patient API MCP Server

- id: lab-1 date: 2023-12-15 test_name: Complete Blood Count ordering_provider: Dr. Patricia Williams results: - component: WBC value: "8.2" unit: K/uL reference_range: 4.5-11.0 status: normal - component: Hemoglobin value: "11.5" unit: g/dL reference_range: 13.5-17.5 status: low - component: Platelets value: "285" unit: K/uL reference_range: 150-400 status: normal - id: lab-2 date: 2023-12-15 test_name: Comprehensive Metabolic Panel ordering_provider: Dr. Patricia Williams results: - component: Glucose value: "95" unit: mg/dL reference_range: 70-100 status: normal - component: Creatinine value: "0.9" unit: mg/dL reference_range: 0.7-1.3 status: normal - component: ALT value: "32" unit: U/L reference_range: 7-56 status: normal - component: AST value: "28" unit: U/L reference_range: 10-40 status: normal - component: Albumin value: "3.8" unit: g/dL reference_range: 3.5-5.0 status: normal - id: lab-3 date: 2024-03-20 test_name: Tumor Markers ordering_provider: Dr. Michael Anderson results: - component: CEA value: "185" unit: ng/mL reference_range: <3.0 status: high - component: CA 19-9 value: "125" unit: U/mL reference_range: <37 status: high - id: lab-4 date: 2024-05-20 test_name: Complete Blood Count ordering_provider: Dr. Michael Anderson results: - component: WBC value: "4.2" unit: K/uL reference_range: 4.5-11.0 status: low - component: Hemoglobin value: "11.2" unit: g/dL reference_range: 13.5-17.5 status: low - component: Platelets value: "185" unit: K/uL reference_range: 150-400 status: normal - component: ANC value: "2.8" unit: K/uL reference_range: ">1.5" status: normal - id: lab-5 date: 2024-05-20 test_name: Comprehensive Metabolic Panel ordering_provider: Dr. Michael Anderson results: - component: Creatinine value: "0.8" unit: mg/dL reference_range: 0.7-1.3 status: normal - component: ALT value: "45" unit: U/L reference_range: 7-56 status: normal - component: AST value: "38" unit: U/L reference_range: 10-40 status: normal - component: Total Bilirubin value: "0.9" unit: mg/dL reference_range: 0.3-1.2 status: normal - id: lab-6 date: 2024-05-20 test_name: Tumor Markers ordering_provider: Dr. Michael Anderson results: - component: CEA value: "95" unit: ng/mL reference_range: <3.0 status: high - id: lab-7 date: 2024-07-15 test_name: Complete Blood Count ordering_provider: Dr. Michael Anderson results: - component: WBC value: "5.5" unit: K/uL reference_range: 4.5-11.0 status: normal - component: Hemoglobin value: "12.1" unit: g/dL reference_range: 13.5-17.5 status: low - component: Platelets value: "225" unit: K/uL reference_range: 150-400 status: normal - id: lab-8 date: 2024-07-15 test_name: Tumor Markers ordering_provider: Dr. Michael Anderson results: - component: CEA value: "42" unit: ng/mL reference_range: <3.0 status: high - id: lab-9 date: 2024-09-10 test_name: Complete Blood Count ordering_provider: Dr. Michael Anderson results: - component: WBC value: "6.2" unit: K/uL reference_range: 4.5-11.0 status: normal - component: Hemoglobin value: "12.8" unit: g/dL reference_range: 13.5-17.5 status: low - component: Platelets value: "242" unit: K/uL reference_range: 150-400 status: normal - id: lab-10 date: 2024-09-10 test_name: Tumor Markers ordering_provider: Dr. Michael Anderson results: - component: CEA value: "38" unit: ng/mL reference_range: <3.0 status: high - id: lab-11 date: 2024-10-15 test_name: Comprehensive Metabolic Panel ordering_provider: Dr. Michael Anderson results: - component: Sodium value: "138" unit: mmol/L reference_range: 136-145 status: normal - component: Potassium value: "4.2" unit: mmol/L reference_range: 3.5-5.0 status: normal - component: Creatinine value: "0.9" unit: mg/dL reference_range: 0.7-1.3 status: normal - component: ALT value: "68" unit: U/L reference_range: 7-56 status: high - component: AST value: "72" unit: U/L reference_range: 10-40 status: high - component: Alkaline Phosphatase value: "185" unit: U/L reference_range: 40-130 status: high - component: Total Bilirubin value: "1.5" unit: mg/dL reference_range: 0.3-1.2 status: high - component: Albumin value: "3.2" unit: g/dL reference_range: 3.5-5.0 status: low - id: lab-12 date: 2024-11-18 test_name: Complete Blood Count ordering_provider: Dr. Michael Anderson results: - component: WBC value: "5.8" unit: K/uL reference_range: 4.5-11.0 status: normal - component: Hemoglobin value: "10.8" unit: g/dL reference_range: 13.5-17.5 status: low - component: Platelets value: "198" unit: K/uL reference_range: 150-400 status: normal - component: ANC value: "3.2" unit: K/uL reference_range: ">1.5" status: normal - id: lab-13 date: 2024-11-18 test_name: Tumor Markers ordering_provider: Dr. Michael Anderson results: - component: CEA value: "125" unit: ng/mL reference_range: <3.0 status: high - component: CA 19-9 value: "245" unit: U/mL reference_range: <37 status: high - id: lab-14 date: 2024-11-20 test_name: Molecular Testing ordering_provider: Dr. Michael Anderson results: - component: KRAS Status value: "Wild-type" unit: "" reference_range: "" status: normal - component: NRAS Status value: "Wild-type" unit: "" reference_range: "" status: normal - component: BRAF V600E value: "Not detected" unit: "" reference_range: "" status: normal - component: MSI Status value: "MSS (Microsatellite Stable)" unit: "" reference_range: "" status: normal - id: lab-15 date: 2024-12-10 test_name: Complete Blood Count ordering_provider: Dr. Michael Anderson results: - component: WBC value: "4.8" unit: K/uL reference_range: 4.5-11.0 status: normal - component: Hemoglobin value: "10.2" unit: g/dL reference_range: 13.5-17.5 status: low - component: Platelets value: "175" unit: K/uL reference_range: 150-400 status: normal - id: lab-16 date: 2024-12-15 test_name: Coagulation Panel ordering_provider: Dr. Michael Anderson results: - component: PT value: "13.2" unit: seconds reference_range: 11.0-13.5 status: normal - component: INR value: "1.1" unit: "" reference_range: 0.8-1.2 status: normal - component: PTT value: "28" unit: seconds reference_range: 25-35 status: normal - id: lab-17 date: 2024-01-18 test_name: Surgical Pathology ordering_provider: Dr. James Martinez results: - component: Specimen Type value: "Colon biopsy, sigmoid" unit: "" reference_range: "" status: normal - component: Diagnosis value: "Invasive moderately differentiated adenocarcinoma" unit: "" reference_range: "" status: abnormal - component: Lymphovascular Invasion value: "Present" unit: "" reference_range: "Absent" status: abnormal - component: MSI Status value: "Microsatellite Stable (MSS)" unit: "" reference_range: "" status: normal report: | SPRINGFIELD PATHOLOGY ASSOCIATES Surgical Pathology Report Patient: Robert Chen MRN: MRN003 Date of Procedure: January 15, 2024 Date of Report: January 18, 2024 Specimen: Colon biopsy, sigmoid CLINICAL HISTORY: 56-year-old male with rectal bleeding, change in bowel habits, and sigmoid mass seen on colonoscopy. GROSS DESCRIPTION: Received in formalin labeled "sigmoid colon biopsy" are six fragments of tan-pink tissue ranging from 0.2 to 0.4 cm in greatest dimension. All tissue submitted in two cassettes. MICROSCOPIC DESCRIPTION: Sections show colonic mucosa with an invasive adenocarcinoma. The tumor is moderately differentiated and consists of malignant glands infiltrating through the muscularis mucosae into the submucosa. There is associated desmoplastic stromal reaction and lymphovascular space invasion is identified. The malignant glands show enlarged, hyperchromatic nuclei with prominent nucleoli and increased mitotic activity. Areas of necrosis are present. IMMUNOHISTOCHEMISTRY: CK20: Positive CDX2: Positive CK7: Negative MLH1: Retained nuclear expression MSH2: Retained nuclear expression MSH6: Retained nuclear expression PMS2: Retained nuclear expression MOLECULAR: Microsatellite instability testing: Microsatellite stable (MSS) DIAGNOSIS: SIGMOID COLON, BIOPSY: - INVASIVE MODERATELY DIFFERENTIATED ADENOCARCINOMA - LYMPHOVASCULAR INVASION PRESENT - TUMOR IS MICROSATELLITE STABLE COMMENT: This is a conventional colonic adenocarcinoma. Retained expression of mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) indicates microsatellite stable tumor. Clinical correlation and staging studies recommended to determine extent of disease and guide treatment decisions. Pathologist: Dr. Elizabeth Morgan, MD Board Certified Anatomic and Clinical Pathology Date Signed: January 18, 2024 - id: lab-18 date: 2024-11-25 test_name: Cytopathology ordering_provider: Dr. Sarah Thompson results: - component: Specimen Type value: "Peritoneal fluid (ascites)" unit: "" reference_range: "" status: normal - component: Cytology value: "Positive for malignant cells" unit: "" reference_range: "Negative" status: abnormal - component: Cell Type value: "Metastatic adenocarcinoma" unit: "" reference_range: "" status: abnormal - component: SAAG value: "0.8" unit: g/dL reference_range: ">1.1 (transudative)" status: abnormal report: | SPRINGFIELD CYTOLOGY LABORATORY Fluid Cytology Report Patient: Robert Chen MRN: MRN003 Date of Procedure: November 22, 2024 Date of Report: November 25, 2024 Specimen: Peritoneal fluid (ascites) CLINICAL HISTORY: 56-year-old male with metastatic colorectal cancer on chemotherapy. New-onset ascites identified on recent CT imaging. Diagnostic paracentesis performed. GROSS DESCRIPTION: Received 500 mL of straw-colored, slightly turbid peritoneal fluid in sterile container. Fluid processed for cytological examination and cell block preparation. MICROSCOPIC DESCRIPTION: Cytospin preparations and cell block sections show numerous three-dimensional clusters and sheets of malignant epithelial cells in a background of mesothelial cells, lymphocytes, and macrophages. The malignant cells display: - Enlarged hyperchromatic nuclei with irregular nuclear contours - Prominent nucleoli - Increased nuclear to cytoplasmic ratio - Moderate eosinophilic cytoplasm - Occasional glandular/acinar formation Background shows reactive mesothelial cells with no evidence of atypia. No microorganisms identified on Gram stain. IMMUNOHISTOCHEMISTRY (Cell Block): CK20: Positive (diffuse) CDX2: Positive CK7: Negative Calretinin: Negative in malignant cells (positive in mesothelial cells) CEA: Positive The immunophenotype is consistent with colonic/lower GI tract origin. DIAGNOSIS: PERITONEAL FLUID, PARACENTESIS: - POSITIVE FOR MALIGNANT CELLS - CONSISTENT WITH METASTATIC ADENOCARCINOMA - MORPHOLOGY AND IMMUNOPROFILE COMPATIBLE WITH COLORECTAL PRIMARY COMMENT: The cytologic findings confirm malignant ascites in this patient with known metastatic colorectal carcinoma. The presence of tumor cells in peritoneal fluid indicates peritoneal involvement, though no discrete peritoneal masses were identified on recent CT imaging. This represents disease progression. Clinical correlation is recommended regarding adjustment of systemic therapy. FLUID ANALYSIS (sent to Chemistry): Total Protein: 3.8 g/dL (elevated) LDH: 285 U/L (elevated) Serum-Ascites Albumin Gradient (SAAG): 0.8 g/dL (exudative) Cell Count: 1,850 WBC/μL (elevated) Findings consistent with malignant (exudative) ascites. Cytopathologist: Dr. Elizabeth Morgan, MD Board Certified Anatomic and Clinical Pathology Date Signed: November 25, 2024