Inspiration
A Catastrophic Life Care Plan is the most important document in any spinal-cord, brain-injury, burn, or amputation lawsuit — but it costs the family $6,000–$7,500, takes 4–6 weeks to produce by hand, and 90% of the patients who need one never get one.
Self-funded plaintiffs, Medicaid-bound families, and public-defender clients are simply priced out of a deliverable that anchors their entire settlement. Lastmile collapses that 4-week, $7,500 deliverable into one chat prompt inside Prompt Opinion.
What it does
A clinician, case manager, or attorney opens a patient in Po, types one sentence — "draft a catastrophic care plan" — and gets back two hosted HTML reports that replicate what a board-certified Life Care Planner charges thousands for.
The clinical Life Care Plan — five differentiators
| Layer | What it adds |
|---|---|
| 📈 SVG trajectory timeline | The whole 6-month course as 14 color-coded event dots — admission → surgery → ICU → rehab → discharge. Pure-Python regex extraction, no LLM. |
| 📚 LLM-generated 7-section body | Patient summary, functional baseline, 13 care-plan categories with annual costs, predictable complications, year-by-year cost projection, prognosis, review notes. |
| 🔬 PubMed evidence grounding | Every prognosis claim cites a real, recent peer-reviewed paper. Click any [PMID] in the report and verify. |
| ⚠️ Pre-discharge red-flag audit | Surfaces required-workup items the chart is missing. For our demo patient it caught 6 real gaps — 2 critical. |
| 📊 NSCISC actuarial projection | Life-expectancy + lifetime medical cost via Monte Carlo (10,000 simulations), rendered inline as a fan chart. The legally defensible spine. |
Demo patient — Marcus Chen, 28M, C6 ASIA-A tetraplegia: Life expectancy 33.1 yr (95% CI 28.2–38.1) vs. 51.2 yr for the non-injured cohort — 18.1-year reduction. Lifetime medical cost: $8.01M median, 90% CI $5.16M–$11.5M.
The family summary
A plain-English, 6th-grade reading-level companion document — what the injury means, what to expect, daily care, equipment, costs, complications, self-care for caregivers. Generated in parallel with the clinical report.
How we built it
Architecture
Prompt Opinion
(patient context + FHIR creds)
│
│ A2A v1 protocol
│ (SHARP fhir-context extension)
▼
┌───────────────────────────────────────────┐
│ Lastmile External A2A Agent │
│ │
│ generate_complete_lcp_report() ← 1 tool │
│ │
│ 1. Fetch FHIR DocumentReferences │
│ 2. Classify injury domain │
│ 3. Extract patient details (regex) │
│ 4. PubMed E-utilities → 5 citations │
│ 4b. SVG timeline (deterministic) │
│ 4c. Red-flag audit (deterministic) │
│ 5. NSCISC Monte Carlo (10K simulations) │
│ 6+7. Gemini clinical + family (parallel) │
│ 8. Write 2 hosted HTML reports │
└───────────────────────────────────────────┘
│
▼
chat-card with 2 clickable URLs
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