AI Conversations

23 escalated conversations requiring physician review

+5
23
Pending Review
-3 min
12m
Avg Escalation Wait
+6
18
Resolved Today
+0.2
4.7
Patient Satisfaction

Escalation Queue

David Lee MRN: 305718
Medication 8 messages
Twin: 72% Medication 15 min ago
Conversation Summary
Patient: "The metformin is really bothering my stomach lately. I've been skipping it some days when I know I'll be out. Is there something else I can take?"
Digital Twin: Recommended taking with food and flagged for physician review to discuss extended-release alternative. Detected 72% adherence drop over 2 weeks via smart pill bottle data.
Escalation reason: Patient requesting medication change. Adherence dropped to 72%. Twin confidence below threshold for autonomous recommendation. Physician approval required for Metformin ER switch.
Proposed AI Response (awaiting approval)
"I've discussed your concerns with Dr. Chen. She's recommending we switch you to Metformin Extended-Release, which is much gentler on the stomach. The pharmacy will have it ready for you. Please continue taking your current medication with food until you pick up the new prescription."
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Jennifer Taylor MRN: 692014
Diagnosis 12 messages
Twin: 45% Diagnosis 32 min ago
Conversation Summary
Patient: Reporting 3 weeks of worsening fatigue, joint pain in hands and wrists, and a rash across cheeks and nose. Has been taking OTC ibuprofen with minimal relief.
Digital Twin: Symptom pattern analysis suggests possible autoimmune etiology (SLE vs RA). Recommended ANA panel, CBC with diff, ESR/CRP, and rheumatology referral. Low confidence — needs physician guidance for workup prioritization.
Escalation reason: Complex multi-system symptoms with low diagnostic confidence (45%). Potential autoimmune condition requiring specialist workup. Twin unable to narrow differential without physician input.
Proposed AI Response (awaiting approval)
"Jennifer, thank you for describing your symptoms so thoroughly. Dr. Chen has reviewed your case and would like to order some blood tests to help us understand what's going on. She's also arranging a referral to a rheumatologist. We'll have the lab orders sent to your preferred lab today."
Thomas Anderson MRN: 841027
Monitoring 4 messages
Twin: 88% Monitoring 1h ago
Conversation Summary
Patient: Asked about recent BP readings — wants to know if medication is working. Reports feeling "normal" with no headaches.
Digital Twin: Analyzed 30-day BP trend from Withings BPM: avg 128/82 (stable, well-controlled). Wearable data confirms consistent medication timing. Recommends continuing current regimen with next check-in in 30 days.
Escalation reason: Routine sign-off required. Digital Twin recommends maintaining current treatment plan. High confidence (88%) — needs physician confirmation before communicating to patient.
Proposed AI Response (awaiting approval)
"Great news, Thomas! Your blood pressure has been very well controlled over the past month — averaging 128/82, which is right where we want it. Dr. Chen has reviewed your data and recommends continuing with your current medication. Keep up the great work! We'll check in again in about 30 days."
Emily Davis MRN: 629481
Symptoms 6 messages
Twin: 61% Symptoms 1.5h ago
Conversation Summary
Patient: Reported intermittent chest tightness and shortness of breath during light activity over the past 5 days. No history of cardiac issues. Concerned about heart.
Digital Twin: Cross-referenced wearable HR data showing elevated resting HR (82 vs baseline 72). Apple Watch ECG shows normal sinus rhythm. Differential includes cardiac vs respiratory etiology. Recommends in-office ECG and possible stress test.
Escalation reason: New cardiac symptoms in patient without prior cardiac history. Elevated resting HR detected by wearable. Twin unable to rule out significant pathology — requires clinical judgment for workup plan.
Proposed AI Response (awaiting approval)
"Emily, I appreciate you telling us about these symptoms. Dr. Chen has reviewed your wearable data and wants to bring you in for an ECG to check your heart rhythm more thoroughly. Please call our office to schedule an appointment this week. If the chest tightness becomes severe or you feel dizzy, please go to the ER."
Michael Brown MRN: 847261
Medication 5 messages
Twin: 68% Medication 2h ago
Conversation Summary
Patient: Asking about taking fish oil and turmeric supplements. Currently on Warfarin. "My friend said these are good for the heart."
Digital Twin: Flagged potential drug interaction — both fish oil and turmeric have anticoagulant properties and may increase bleeding risk when combined with Warfarin. Advised patient to wait for physician guidance before starting supplements.
Escalation reason: Potential drug-supplement interaction with anticoagulant. Twin correctly identified bleeding risk but requires physician sign-off on supplement guidance for patient on Warfarin.
Proposed AI Response (awaiting approval)
"Michael, good question! It's important to check with us before adding any supplements when you're on Warfarin. Both fish oil and turmeric can increase bleeding risk. Dr. Chen recommends avoiding these for now. If you're interested in heart-healthy supplements, we can discuss safe alternatives at your next appointment."

AI Performance

Last 30 days
Resolved Without Escalation
78%
Response Accuracy
94%
Physician Approval Rate
91%
Patient Engagement
86%
Appropriate Escalation
97%

Top Escalation Reasons

This month
1 Medication change or dosage adjustment 87 28%
2 New or worsening symptoms 64 21%
3 Routine monitoring sign-off 58 19%
4 Low confidence diagnostic question 42 14%
5 Drug interaction or contraindication 31 10%
6 Wearable anomaly requiring interpretation 25 8%