Triage & Driving Clearance¶

Source: Call 34 (3-3), Call 35 (3-18) Priority: Tier 3 — needs Lauryn's clinical input at 3/25 visit KB Requirement IDs: #130-#136

The Problem¶

Driving clearance is one of the most common patient questions and one of the most nuanced. There's no magic day or fixed timeframe. The answer depends on multiple signals that the system needs to integrate.

Bawa: "The driving thing is always a little bit of a tricky one... there's no like magic timeframe or magical day."

Current protocol has a basic driving restriction but it's not nearly detailed enough for the AI to reason through.

Requirements From Bawa (3-18)¶

No simple timeframe (KB #130)¶

Bawa: "There's no like magic timeframe or magical day."

Don't hardcode "6 weeks." The answer is conditional.

Reasoning quality bar (KB #131)¶

Bawa: "I think the AI should be able to answer it comparable to help me with."

The AI's driving guidance should approximate how Bawa himself would reason through it.

Depends on procedure + timeframe (KB #132)¶

Bawa: "That'll be dependent on what they've had done and what timeframe they're at."

Right-side surgery is trickier (brake pedal leg). Procedure type matters.

Integrate medication status (KB #133)¶

Bawa: "It should also integrate with the medication feature... hey, it looks like you're still taking the Percocet... can't be driving while you're on the pain medication."

If patient is logging opioid use, driving is a no.

Integrate assistive device status (KB #134)¶

Bawa: "If it's asking you, are you still using a cane, or are you still using a walker... how are you progressing."

Walker → definitely not ready. Cane → getting closer. No device → one more factor cleared.

Explain reasoning with integrated context (KB #135)¶

Bawa: "We see that you're still on a Walker and you're on pain medication... we saw that you took the narcotic pills three times yesterday... we got to work on a few of these things before we think it's safe for you to drive."

Don't just say "not yet." Explain WHY using the patient's actual data — what they're taking, what device they're using, their progress trajectory.

Defer to PT for official clearance (KB #136)¶

Lauryn: "Discuss this with your physical therapist. They can check your reaction time... who can officially clear them."

Even when all signals look good, the system defers to PT or next clinical visit for official clearance. The AI never says "you're cleared to drive."

Requirements From Bawa (3-3)¶

Activity restriction timelines¶

Bawa gave detailed timing from memory (3-3 call):

Activity	Restriction period
Golf	0-63 days
Tennis/Pickleball	0-84 days
Running	0-84 days
Driving	0-42 days (baseline, but conditional)
Swimming	0-42 days
Skiing	0-84 days
International travel	0-84 days
Climbing	0-84 days

These are already implemented as protocol components with trigger_day/end_day ranges.

Catch-all triage for unknown activities¶

Bawa (3-3): Need a mechanism for activities the protocol doesn't cover (e.g., paragliding).

When patient asks about an activity not in the protocol, the system should: 1. Acknowledge the question 2. Say it's not something we have specific guidance on 3. Recommend discussing with PT or at next visit 4. Log it as a gap for the Conversation Factory

Driving Clearance Decision Tree¶

Based on both calls, the driving triage should evaluate:

Patient asks about driving
    │
    ├── Check procedure type
    │   └── Right side → extra caution (brake pedal leg)
    │
    ├── Check post-op day vs restriction period
    │   └── Within 0-42 days → "Your surgeon asks that you wait"
    │
    ├── Check medication status (from med tracking)
    │   └── On opioids → "Can't drive while on pain medication"
    │   └── When did they last take it? (yesterday 3x = not ready)
    │
    ├── Check assistive device status
    │   └── Walker → "You're still on a walker"
    │   └── Cane → "Getting closer, but discuss with PT"
    │   └── None → one more factor cleared
    │
    ├── All factors clear?
    │   └── Still defer: "Discuss with your PT who can check your reaction time"
    │
    └── Response format:
        - Acknowledge the desire ("I totally get wanting to drive again")
        - Explain current status using their data
        - Identify what needs to change
        - Redirect to PT/provider for official clearance

3/25 Visit Plan¶

Driving clearance is a prime topic for rapid-fire Q&A with Lauryn: - What exactly does she tell patients about driving? - What signals does she use to assess readiness? - How does right-side vs left-side change her guidance? - What about patients who drive themselves to PT? - At what point does she consider someone cleared?

Capture her answers → feed into Conversation Factory → build protocol content → scenarios pass.

General Triage Improvements¶

Beyond driving, the triage system should integrate patient data the same way for all clearance-type questions: - Swimming → wound healing status - Golf → weight bearing, ROM - Return to work → physical demands of job - Travel → blood clot risk, medication access

Each follows the same pattern: check multiple signals, explain reasoning, defer to provider.