{
  "id": "upper-gi-bleed",
  "title": "Upper GI bleed \u2014 transfusion and acid suppression",
  "patient_id": "pat-1005",
  "encounter_id": "enc-1005",
  "role": "Attending Physician",
  "objective": "As the attending physician, review hemoglobin trend and coag panel, place PRBC transfusion and IV pantoprazole, document the bleed severity, hemodynamics, and GI consultation need, then sign the encounter.",
  "required_orders": [
    "Packed red blood cells",
    "Pantoprazole IV"
  ],
  "required_note_elements": [
    "Hemoglobin trend",
    "Hemodynamic status",
    "Glasgow-Blatchford score",
    "Transfusion plan",
    "GI consultation indication"
  ],
  "scoring": {
    "base_reward": 1.0,
    "substeps": {
      "order:Packed red blood cells": 0.15,
      "order:Pantoprazole IV": 0.08,
      "note_element:Hemoglobin trend": 0.12,
      "note_element:Hemodynamic status": 0.1,
      "note_element:Glasgow-Blatchford score": 0.1,
      "note_element:Transfusion plan": 0.1,
      "note_element:GI consultation indication": 0.1,
      "encounter_signed": 0.25
    }
  }
}