The patient who stopped
coming back.
UroLumen is a daily worklist for a urology practice's prostate-cancer patients. It re-reads every chart on your panel every day and gives you one ordered list: who needs you to look at their chart this week, and exactly why. No composite score, no black box — every row cites the specific rule that fired.
How the worklist actually works
Every patient on your panel is sorted into one of five lanes every day. A patient can only ever be in one lane at a time — the one that needs a human first. Review bands say when to look at the chart, not when to treat the patient: every threshold is a configurable house default, not a validated cutoff.
Blocked
A sentinel that could not run — a missing treatment date, a missing testosterone — because a wrong answer here is worse than no answer.
Moving
Disease that is changing right now: a recurrence trajectory, a castration-resistance tripwire, a sequencing decision point.
Lapsed
An interval that's overdue — a surveillance biopsy, a PSA recheck, a bone-density scan — measured against the protocol actually on the chart.
Unopened
An eligibility door that hasn't been walked through: a candidate for a trial, a genomic test never ordered, a discussion never had.
Staff
A data-quality fix, not a clinical one — a duplicate PSA, a future-dated result, a Gleason that doesn't match the note. Routed to staff, not the doctor.
26 engines, six of the ones that matter most
Each one is a deterministic, testable rule — not a model guessing. Every finding names the exact evidence it fired on and the exact next step, from a first elevated PSA through active surveillance, recurrence, castration resistance, and sequencing of advanced therapy.
Recurrence sentinel
Phase-aware PSA recurrence detection — Phoenix nadir+2 after radiation, 0.2 after prostatectomy — not one flat threshold for every patient.
Castration-resistance tripwire
Flags a real CRPC pattern (castrate testosterone + confirmed progression) before it's obvious on a lab-by-lab read, non-metastatic or metastatic.
Sequencing radar
HRR/genomic testing never ordered, ARPI-after-ARPI sequencing, the Lu-177-PSMA prerequisite gate — the advanced-disease decisions that are easy to miss.
Active-surveillance kinetics
PSA doubling time and velocity against real reclassification triggers, not a generic trend line.
Trust gate
Catches inter-observer Gleason discordance and an unverified CRPC label before either one silently drives a risk score.
Note-consistency check
Every number asserted in a dictated note is checked against deterministic urology math before it's saved.
Four ways to add a patient
Paste report text, drop a PDF or Word file (print to PDF from any EHR — Epic, NextGen, athenahealth, eCW, ModMed all work identically), import a FHIR bundle or C-CDA export, or enter a full longitudinal case by hand. UroLumen extracts the structured values so you confirm rather than type. Nothing is uploaded anywhere, and nothing is saved until you add it — extraction is deterministic pattern matching, not an LLM, so it will occasionally miss an unusual phrasing. When it does, it says so and asks rather than guessing.
Local-first, on purpose
Your panel lives in this browser and nowhere else — there is no server copy of your patients. Clearing site data or switching machines loses it, so the app prompts you to export a plain-JSON backup regularly. When a harder question needs a governed AI read (interpreting a PSMA-PET report, for example), identifiers are stripped before any model sees the text, every claim is cited to a dated evidence corpus, and the result is signed with an Ed25519 Duty-of-Care Record you can verify offline, years later.
Clinician sign-in
Access is limited to clinicians your practice has approved — this isn't open sign-up. Enter the email address that was approved for you, and we'll send a one-click sign-in link. No password to remember or leak.
UroLumen is clinical decision support for licensed clinicians. Not a diagnostic device. Not FDA-cleared. The treating clinician is solely responsible for all clinical decisions. Review bands say when a human should look at the chart, not when a patient should be treated.