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Overview

Suspecting automatically detects potential conditions based on clinical evidence patterns from patient medical records. The system analyzes clinical data including laboratory results, medications, procedures, and documented conditions to identify patients who may have undiagnosed conditions. Suspects are stored as unconfirmed Condition resources in the data warehouse, allowing them to coexist with confirmed diagnoses while remaining clearly identifiable through the VERIFICATION_STATUS field. Suspecting runs at scheduled intervals and analyzes your patient population to identify potential conditions that may require clinical review or follow-up.

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Available Conditions

The following conditions are supported by the suspecting system:

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Mental Health

Condition
Bipolar Disorder
Depression
Dementia
Seizure Disorder
Anorexia and Bulimia
Alcohol Use Disorder

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Cardiovascular

Condition
Heart Failure
Hypertension
Coronary Artery Disease
Peripheral Arterial Disease
Carotid Artery Stenosis
Angina
Arrhythmia
Aortic Aneurysm
History of CVA

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Metabolic

Condition
Morbid Obesity
Diabetes
Prediabetes
Hyperlipidemia
Hyperparathyroidism
Hypothyroidism

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Respiratory

Condition
COPD
Asthma
Obstructive Sleep Apnea

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Renal/Hepatic

Condition
Chronic Kidney Disease
Cirrhosis
Chronic Hepatitis C

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Other

Condition
Diabetic Retinopathy
Retinal Vein Occlusion
Age-Related Macular Degeneration
Lung Nodule
Thyroid Nodule
Barrett’s Esophagus
Benign Carcinoid
Bone Density
Amputation
Ostomy
History of Active Cancer

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Getting Started

Suspecting runs at scheduled intervals and analyzes your patient data to identify potential conditions. Once suspecting is enabled for your account, results will be available through the API and data warehouse.

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Accessing via API

You can retrieve suspect records using the /medical/v1/suspect endpoint. Suspects are returned as FHIR Condition resources with verificationStatus set to unconfirmed.

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Accessing via Data Warehouse

Suspect records are stored in the CONDITION table alongside confirmed diagnoses. Suspects are distinguished by VERIFICATION_STATUS = 'unconfirmed'.

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Key Suspect Fields

The following fields are specific to suspects:
ColumnDescription
VERIFICATION_STATUSSet to unconfirmed for suspects
EVIDENCEJSON array of evidence references supporting the suspect

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Evidence Structure

The EVIDENCE column contains a JSON array of evidence references. Each evidence object includes: 
[
  {
    "detail": [
      {
        "reference": "Observation/019b0bf4-68e3-79c2-9538-ed8a47041dbd",
        "display": "Lithium detected"
      }
    ]
  },
  {
    "detail": [
      {
        "reference": "MedicationStatement/019c1cf5-79f4-8ad3-a649-fe9b58152ece",
        "display": "Active prescription for lithium carbonate"
      }
    ]
  }
]
Each evidence object contains:
  • detail: Array of references to supporting resources
  • reference: FHIR resource reference (e.g., Observation/019b0bf4-68e3-79c2-9538-ed8a47041dbd, MedicationStatement/019c1cf5-79f4-8ad3-a649-fe9b58152ece)
  • display: Human-readable explanation of why this evidence supports the suspect

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Example Queries

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Find all suspects for a patient

SELECT
  CONDITION_ID,
  PATIENT_ID,
  ICD_10_CM_CODE,
  ICD_10_CM_DISPLAY,
  EVIDENCE,
  RECORDED_DATE
FROM CONDITION
WHERE PATIENT_ID = 'patient-123'
  AND VERIFICATION_STATUS = 'unconfirmed'
ORDER BY RECORDED_DATE DESC;

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Find all patients with a specific suspect condition

SELECT
  PATIENT_ID,
  ICD_10_CM_CODE,
  ICD_10_CM_DISPLAY,
  RECORDED_DATE
FROM CONDITION
WHERE VERIFICATION_STATUS = 'unconfirmed'
  AND ICD_10_CM_CODE = 'R7303'
ORDER BY RECORDED_DATE DESC
LIMIT 10;

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Count suspects by condition type

SELECT
  ICD_10_CM_CODE,
  ICD_10_CM_DISPLAY,
  COUNT(DISTINCT PATIENT_ID) as patient_count
FROM CONDITION
WHERE VERIFICATION_STATUS = 'unconfirmed'
  AND RECORDED_DATE >= DATEADD(day, -30, CURRENT_DATE())
GROUP BY ICD_10_CM_CODE, ICD_10_CM_DISPLAY
ORDER BY patient_count DESC;

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The Suspect Model

When a suspect is identified, the API returns a FHIR Condition resource with the following structure: 
{
  "resourceType": "Condition",
  "id": "019b0bf4-68e3-79c2-9538-ed8a47041dbd",
  "clinicalStatus": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
        "code": "active"
      }
    ]
  },
  "verificationStatus": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
        "code": "unconfirmed",
        "display": "Unconfirmed"
      }
    ]
  },
  "category": [
    {
      "coding": [
        {
          "system": "http://metriport.com/fhir/CodeSystem/condition-category",
          "code": "suspect",
          "display": "Algorithmic Suspect"
        }
      ]
    }
  ],
  "code": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/sid/icd-10-cm",
        "code": "F31.9",
        "display": "Bipolar disorder, unspecified"
      }
    ]
  },
  "subject": {
    "reference": "Patient/patient-123"
  },
  "recordedDate": "2025-12-05",
  "evidence": [
    {
      "detail": [
        {
          "reference": "Observation/019b0bf4-68e3-79c2-9538-ed8a47041dbd",
          "display": "Lithium detected"
        }
      ]
    },
    {
      "detail": [
        {
          "reference": "MedicationStatement/019c1cf5-79f4-8ad3-a649-fe9b58152ece",
          "display": "Active prescription for lithium carbonate"
        }
      ]
    }
  ]
}
For complete schema details, migration information, and advanced queries, see: