deremer/mychart-advisor

Answers the family's questions about the patient's records from the case folder, with citations: what a result or term means, how a value has trended, whether a test came back, what the notes say the plan is, what the possibilities are, and what to ask the care team about a medication, test, or decision. Use for any question about the patient, the labs, imaging, notes, medications, or what is going on, such as "what does this result mean", "is his kidney function getting worse", "did the biopsy come back", "what could be causing this", "should we worry about", or "should they stop that drug".

Convenes a multi-specialty case conference on the patient's records: specialist seats chosen for this case read the indexed chart in parallel and write independent assessments, a contrarian investigator attacks the emerging consensus, a synthesizer writes a conference note with a ranked differential, open disagreements, and questions for the treating team, and a second reader checks every claim against the records. Use when someone says "case conference", "run the panel", "specialist review", "what are we missing", "get a second look", or "what could this be", or after ingest-results recommends a conference. Takes 10 to 20 minutes and a substantial number of tokens.

Sets up a new case folder for tracking a patient's portal records (Epic MyChart or another patient portal): creates the folder structure, the case instructions file, and a start-here guide, and records the handful of facts every other skill needs. Use when someone says "set up a case", "start tracking my mom's results", "new case folder", "get started with mychart-advisor", or "first time using this", or when another mychart-advisor skill finds no case AGENTS.md. Safe to rerun to repair a folder.

Designs the case conference panel for one patient: reads the case folder, interviews the family where the records leave gaps, and chooses the specialist seats this case needs, for example oncology when cancer is on the differential, interventional radiology when a procedure is in play, or a specialty the team has not yet consulted. Writes a roster, an ownership map, and one brief per seat into panel/ so case-conference can run them. Use before the first case conference, when someone says "design the panel", "which specialists should review this", "add a seat", or "update the panel", or when ingest-results says the panel may need a new seat.

Runs a blinded, independent consult on the patient's records, the kind of fresh outside read a family might hire. A team of agents that has not seen the treating team's conclusions or the family's prior analysis builds a fact base, generates every hypothesis the records cannot yet rule out, investigates each family of hypotheses with literature, attacks its own conclusions with a red team, reconciles against the treating team and prior analysis, and produces one verified, cited report with a test plan. Use only when someone explicitly asks for an "independent consult", "blinded second opinion", "fresh unbiased review", or "leave no stone unturned", or for a consult addendum or status. Expensive: from about 10 to 35 or more agents.

Ingests newly downloaded patient-portal PDFs (test results, care team notes, and other records from Epic MyChart or another portal) into a case folder. Extracts the text, rebuilds lab trend tables as CSV and markdown, updates the results and notes indexes, the running summaries, and the discrepancy log, refreshes where the case stands, and writes a short what-changed note the family can read on a phone. Offers to record bedside observations first. Use when someone says "ingest", "new results", "new notes", "I downloaded more files", "update the labs", "what changed", or "refresh the case".

Interviews the patient or family, one topic at a time, to record the patient's history in their own words: the current illness and its timeline, past medical and surgical history, medications and supplements, allergies, family history, exposures and travel, baseline function, earlier workups, and what the family most wants to understand. Writes notes/patient-history.md in the case folder. Use when someone says "patient history", "intake", "add to the history", "I remembered something about his past", "family history", or after case-setup. Resumable and safe to rerun.

Prepares a short, ranked, record-grounded question list for an upcoming conversation with the care team: a one-screen card to use in the room and a detail section with reasons, sources, and what a good answer sounds like. Tailors the list to who the conversation is with and how much time there is, and skips questions the records or the tool can already answer. Use when someone says "prep questions", "what should we ask", "rounds tomorrow", "family meeting", "call with the doctor", "before we talk to the specialist", or "what do I ask the nurse".

Captures what the family saw, heard, or was told at the bedside or at home since the last entry: changes in alertness, thinking, movement, eating, sleep, pain, or mood, new symptoms, reactions after a medication or procedure, and what a doctor or nurse said. Appends a dated entry to notes/bedside-status.md in the case folder and flags anything that conflicts with the chart. Use when someone says "record an observation", "bedside update", "he seemed confused today", "the doctor told us", "log what happened", or "capture what the nurse said". Also runs as the first step of ingest-results.