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{
  "id": "pe-workup",
  "title": "PE \u2014 diagnostic imaging and empiric anticoagulation",
  "patient_id": "pat-1008",
  "encounter_id": "enc-1008",
  "role": "Attending Physician",
  "objective": "As the attending physician, review D-dimer and Wells criteria, place CTA chest and heparin drip, document the PE probability, hemodynamics, and anticoagulation rationale, then sign the encounter.",
  "required_orders": [
    "CT angiography chest",
    "Heparin drip"
  ],
  "required_note_elements": [
    "D-dimer elevation",
    "Wells score",
    "Hypoxia evaluation",
    "Right heart strain",
    "Anticoagulation plan"
  ],
  "scoring": {
    "base_reward": 1.0,
    "substeps": {
      "order:CT angiography chest": 0.13,
      "order:Heparin drip": 0.13,
      "note_element:D-dimer elevation": 0.1,
      "note_element:Wells score": 0.12,
      "note_element:Hypoxia evaluation": 0.1,
      "note_element:Right heart strain": 0.1,
      "note_element:Anticoagulation plan": 0.1,
      "encounter_signed": 0.22
    }
  }
}