Surface 3 — Survivorship risk console
UC 05 · missionSynthetic data · hypothesis modeSurvivorship risk console· 24-month post-treatment cohort
Last refresh 11m ago
Active cohort
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24-month post-treatment
Rising-risk · last 7 days
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Assigned to navigator
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90-day readmit rate
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Rising-risk queue
Click a row for explainability · top 0 shown
RiskPatientPrimary siteSince tx
Select a patient to see risk explainability
Cortex forecastTrained on 36 months of survivorship outcomes
12 new rising-risk patients this week · capacity to absorb in 2 of 3 navigator teams
Pattern cluster detected in Duarte breast cohort — 7 of 12 new rising-risk patients show PRO fatigue + missed appointment signature (predictive of post-treatment depression). Consider reassigning 2 patients to the Phoenix breast navigator for this cycle.
Signal coverage
—Across cohort
PROs, appointment adherence, Rx fill, lab trends, SDOH screen.
Navigator capacity
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Duarte breast team at 94%. Phoenix has headroom.
Model lift vs. baseline
—vs. scheduled follow-up
Identifies intervention-worthy patterns more often.
Intervention → QoL recovery
—Within 30 days
Rolling 6-month cohort outcome after navigator outreach.
Risk model · Cortex ML gradient-boosted ensemble trained on 36 months of survivorship outcomes. Signals: PRO fatigue/pain trends, appointment adherence, Rx fill gaps, lab trajectory, SDOH screens, readmission history. Sources · Epic Beacon, MyChart PROs, Surescripts Rx, Quest/LabCorp feeds, SDOH enrichment.