THE READ · MAY 15, 2026 · CLINICIAN REVIEWED
An early cardiometabolic signal needs review.
HbA1c has moved into prediabetic range, hsCRP is elevated, ApoB is above target, and wearable oxygen data shows recurring dips. The Visit Pack is ready for physician review.
Current picture
Needs review
2 action · 3 attention · 4 stable
Reviewed by
Dr. Chen
Evidence checked before delivery
Navigator
Maya
Review pathway ready
The Signal
6.1
%
HbA1c
Prediabetic
Target: <5.7
Next step
Physician review + repeat labs
3.2
mg/L
hsCRP
High
Target: <1.0
Next step
Inflammation workup
118
mg/dL
ApoB
Elevated
Target: <90
Next step
Lipid risk review
The Pathway
01 · Doctor-facing
Confirm cardiometabolic review
Needs approval
02 · Lab follow-up
Repeat metabolic + lipid labs
Order ready
03 · Screening decision
Discuss CGM + sleep screen
Physician-guided
Centio is Handling
Visit Pack
Prepared for physician review.
Lab follow-up
Repeat panel prepared.
Ledger
Open decisions tracked.
Key Readings
Metabolic & Inflammatory
HbA1c6.1% · prediabetic range
6.1%
hsCRP3.2 mg/L · elevated
3.2
ApoB118 mg/dL · above target
118
Cardiovascular
Blood pressure136/84 · borderline
136/84
LDL88 mg/dL · within target
88
Resting HR58 bpm · excellent
58
Wearable · Oura
HRV48ms · 3-day decline from 72ms
48ms
Sleep score76 · good
76
Steps (7-day avg)8,240 daily
8.2k
May 15, 2026 · Health Brief
The Read
Early cardiometabolic risk signal. Two action signals, three attention signals, and four stable systems.
2 action signals
3 need attention
4 stable systems
Clinician reviewed
Key readings · May 15, 2026
HbA1c6.1% · prediabetic range · physician review
6.1%
hsCRP3.2 mg/L · above optimal · inflammation workup
3.2
ApoB118 mg/dL · elevated particle burden
118
Blood Pressure136/84 · borderline · monitor
136/84
SpO₂ DipsRecurring wearable dips · screen discussion
4%
eGFR92 · stable kidney function
92
ALT / AST31 / 26 · stable liver enzymes
31/26
TSH1.7 mIU/L · stable thyroid marker
1.7
Key findings
Evidence-linked summaryEarly insulin resistance
HbA1c 6.1% and fasting glucose 112 suggest early metabolic drift. This is the primary action signal.
Inflammation above optimal
hsCRP 3.2 mg/L should be confirmed and interpreted with weight trend, sleep, and metabolic context.
Particle burden needs review
ApoB 118 mg/dL warrants a more precise lipid-risk discussion than LDL alone.
Sleep oxygenation screen
Recurring wearable oxygen dips do not diagnose sleep apnea, but they justify a screening discussion.
Priority actions
3 open01 · Doctor-facing
Confirm cardiometabolic review
Review HbA1c, hsCRP, ApoB, BP, and SpO₂ dips with physician.
02 · Lab follow-up
Repeat confirmatory labs
HbA1c, fasting insulin, ApoB, hsCRP, CMP, and lipid panel.
03 · Screening decision
Discuss CGM + sleep screen
Physician to advise on CGM trial and home sleep study screen.
Evidence checked · reviewed by Dr. Chen.
Full Health Brief Report
View the full reviewed report with executive read, signal dashboard, questions, inputs, destination, and closing summary.
What changed
- HbA1c moved into prediabetic range.
- hsCRP elevated above optimal.
- Wearable oxygen dips now recurring.
Evidence used
Lab panel, BP log, weight trend, sleep oxygenation data, medication/supplement list, and family history summary.
Doctor questions
- Should we use CGM for 14 days?
- Should ApoB drive risk targets?
- Is a home sleep study appropriate?
Your next steps
Action Plan
3 open · physician-facing · max 3 at any time
Priority 01 · Physician review · Concierge-routed
Confirm cardiometabolic review
HbA1c, hsCRP, ApoB, borderline BP, and sleep oxygenation dips should be reviewed together. Maya has prepared the Visit Pack and can coordinate the physician appointment.
Priority 02 · Lab follow-up · Order ready
Repeat confirmatory labs
Repeat HbA1c, fasting insulin, ApoB, hsCRP, CMP, and lipid panel before making any intervention decisions. Results will update the Health Brief and Decision Ledger.
Lab follow-up
Priority 03 · Screening decision · Physician-guided
Discuss CGM trial + home sleep study
CGM may clarify glucose variability; home sleep study may clarify oxygen dips. Physician should decide whether either is appropriate.
Doctor-facing
Evidence & Signals
Supporting data behind the cardiometabolic Health Brief
Labs
Apple Health
Evidence behind the May brief
These signals support the reviewed Health Brief. They are presented as evidence and context, not as standalone health recommendations.
HbA1c — 18 Month Trend
Brief evidencePrior: 5.5%
Current: 6.1%
Sleep Oxygenation
Screening discussion4%
Recurring SpO₂ dips · wearable detected
Sleep score76
Resting HR61 bpm
Screen pathAsk physician
Lab Evidence
| Test | Result | Reference / Target | Brief interpretation | Date |
|---|---|---|---|---|
| HbA1c | 6.1% | <5.7% | Prediabetic range | May 10, 2026 |
| hsCRP | 3.2 mg/L | <1.0 mg/L | Inflammation workup | May 10, 2026 |
| ApoB | 118 mg/dL | <90 mg/dL | Lipid risk review | May 10, 2026 |
| Fasting glucose | 112 mg/dL | 70–99 mg/dL | Confirm with repeat | May 10, 2026 |
| eGFR | 92 | >60 | Stable | May 10, 2026 |
| ALT / AST | 31 / 26 | Within range | Stable | May 10, 2026 |
Cardiometabolic Review · May 21
Visit Pack
Ready to share · Expires in 48 hours · End-to-end encrypted
Visit Information
Visit ID
CEN-2026-0441
Visit Date
May 18, 2026
Member
Alexander Rhodes
Physician
Dr. Michael Hayes, Cardiometabolic Specialist
Vitals
BP
118/76
Height
183cm
Weight
82 kg
HR
68 bpm
Flags
● HbA1c — Prediabetic range (6.1%)
● hsCRP — Elevated (3.2 mg/L)
Questions for Doctor
1. Should we use CGM for 14 days?
2. Should ApoB drive lipid risk targets?
3. Is a home sleep study appropriate given oxygen dips?
4. Could sleep fragmentation be contributing to glucose and BP drift?
5. What repeat labs should we run before deciding on treatment?
2. Should ApoB drive lipid risk targets?
3. Is a home sleep study appropriate given oxygen dips?
4. Could sleep fragmentation be contributing to glucose and BP drift?
5. What repeat labs should we run before deciding on treatment?
Centio.One · CEN-2026-0441Page 1 of 2
Supplements
Magnesium Glycinate200mg
Vitamin D32000 IU
Omega-32g EPA/DHA
Recent Medications
No current prescriptions on file.
Shared via end-to-end encrypted secure link. Access expires May 20, 2026.
MB
Maya Bennett
Health Navigator · Active
What Centio is handling
Cardiology consult
Awaiting approval
Visit Pack sharing
Ready
Ferritin + Vitamin D retest
In progress
Post-visit debrief
After consult
Correspondence
All actions are tracked in the task panel and Decision Ledger
PM
Good morning, Alexander. Your latest Health Brief has flagged cortisol elevation and an HRV decline over 3 days. I've reviewed the data and prepared a cardiology referral to Dr. Michael Hayes. He has availability this Thursday at 2pm.
9:12 AM
Specialist Referral Ready
Dr. Michael Hayes · Cardiologist · Massachusetts General Hospital
Yes, please confirm Thursday 2pm and share the visit pack with Dr. Michael Hayes beforehand. Can you also book a follow-up call with me after the appointment?
9:15 AM
PM
Done. Thursday May 21 at 2pm is confirmed. Visit Pack sent securely to Dr. Michael Hayes's clinic. Calendar invite sent. I've also scheduled a debrief call with you on May 22 at 10am.
9:17 AM
Message Maya...
Second Opinion
Clinical Director reviewed · Dr. Elena Cardenas
Verified by Clinical Director
Condition Summary
Early Cardiometabolic Risk Signal
HbA1c, hsCRP, ApoB, borderline blood pressure, and recurring SpO₂ dips suggest an early cardiometabolic risk pattern. Physician evaluation is recommended to clarify significance and next steps.
Clinical Director's Assessment
Pattern suggests early metabolic drift with inflammatory and vascular risk signals. Recommend confirmatory labs, cardiometabolic review, and physician-guided discussion of CGM and sleep screening before any intervention decisions.
Recommended Specialists
Dr. Michael Hayes
4.9
Cardiologist · Massachusetts General Hospital · 3.2km
CardiologyHRV Specialist
Dr. Laura Bennett
4.8
Endocrinologist · Cleveland Clinic · 5.1km
MetabolicHbA1c
Dr. Ethan Brooks
4.7
Preventive Cardiology · Mayo Clinic · 6.8km
IntegrativePrevention
Longitudinal record
Decision Ledger
Alexander Rhodes · evidence, rationale, owner, status, and outcome
2
Open
3
Monitoring
7
Resolved
All
Action Needed
In Progress
Monitoring
Resolved
Decision object
Next step
Target date
Status
Early insulin resistance
HbA1c 6.1% · fasting glucose 112 · opened May 2026
PCP/cardiometabolic review + repeat labs
May 21, 2026
Action Needed
Confidence
Medium-high
Risk level
Elevated · review recommended
Owner
Alexander + concierge navigator
Pathway
Doctor-facing · concierge-routed
Rationale: HbA1c is in prediabetic range and fasting glucose is elevated. This should be confirmed and reviewed with physician before any intervention decisions.
Inflammation source
hsCRP 3.2 mg/L · source unclear · opened May 2026
Confirm persistence and evaluate likely drivers
May 24, 2026
Action Needed
ApoB particle burden
ApoB 118 · LDL 132 · lipid-risk review pending
Discuss lipid risk targets with physician
May 24, 2026
Monitoring
Sleep oxygenation
Recurring wearable SpO₂ dips · sleep screen decision pending
Discuss home sleep study screen
May 28, 2026
Decision Pending
Stable organ function
eGFR, liver enzymes, thyroid, Vitamin D stable · May 2026
Routine monitoring only
Nov 2026
Stable
Why this matters
The Decision Ledger turns health findings into accountable objects. Each item carries evidence, rationale, confidence, risk level, owner, target date, and outcome — so the member can see what is unresolved, what is being coordinated, and what has been closed.
Membership & Payments
Centio Guided · payments, receipts, and eligible reimbursement support
HSA Balance
of $2,500 limit
FSA Remaining
$640
Expires Dec 31, 2026
Recent Billing
| Service | Date | Amount | Status | Document |
|---|---|---|---|---|
| Monthly Membership — Guided | May 1, 2026 | $299.00 | Paid | — |
| Lab Panel — Comprehensive | May 10, 2026 | $180.00 | Paid | Download LON |
| Monthly Membership — Guided | Apr 1, 2026 | $299.00 | Paid | — |
| Specialist Referral — Concierge | Mar 20, 2026 | $50.00 | Paid | Download LON |
Clinical Director
Review Workbench
Queue home · select a work item to enter focused review
My QueueTeam Queue
My Queue
4
Visible tasks
Urgent Review
1
P1 / needs review
Pending Review
2
Second opinion + intake
Resolved Today
7
Ledger updates logged
Review Queue
4 items · sorted by priority
Member
Type
Priority
Submitted
Action
ML
Margaret Liu
Concierge · Statin timing question
Second Opinion
P2
5h ago
JC
James Carter
Guided · New member onboarding
Intake Review
P1
6h ago
AR
Alexander Rhodes
Guided · Cardiometabolic signal
Health Brief
P2
2h ago
Later
RK
Robert King
Guided · Pre-visit preparation
Visit Pack
P3
1d ago
Later
Queue Snapshot
Visible work items by priority and task type. Use this panel to understand queue composition before opening a case.
Total visible
4
P1 / overdue
1
P2 / due today
2
P3 / later
1
Health Brief
1 item · P1 overdue●
1 item · P1 overdue●
Second Opinion + Biomarkers
2 items · due today●
2 items · due today●
Visit Pack
1 item · due May 18●
1 item · due May 18●
Second Opinion Review
Margaret Liu
Request #SO-2026-0140 · Submitted 6 May, 11:08 · Specialist Dr. R. Andersen
Second Opinion Review
Review specialist draft and approve member-facing response.
Review
Evidence
Draft Output
Writeback
Member's original question
“I want to understand whether I should start a statin this year or wait. My Apo B has gone up two readings in a row and my father had a heart attack at 62.”
Evidence package
- Lipid panels, last 3 years, including most recent May 8, 2026
- Carotid IMT report, May 2, 2026, normal
- Family history: paternal cardiac event, maternal Type 2 diabetes
- Oura 180d activity profile; average 8,240 steps
- Current medications: Lisinopril, Metformin
Clinical question reviewed
Should Elena begin a statin this year, or wait?AI Draft
What was reviewed
Three years of lipid panels, recent carotid IMT imaging, family history on both sides, medications, and activity profile. The reviewer question was timing, not necessity.Evidence linked
Specialist conclusion
There is no urgency this calendar year. The ApoB trend is real but unfolding slowly, and inflammation markers and lifestyle still buy time. A coronary calcium score in Q3 will decide the question more clearly than another year of waiting.Needs review
Approval sends the member-facing second opinion, writes rationale to the Decision Ledger, and notifies Maya.
Intake Review · Biomarkers
James Carter
Biomarker import · 32 markers · 7 out-of-range · Submitted today, 08:40
Intake Review
Approve, edit, or flag imported biomarker values before they enter the member record.
Biomarkers
Member Intake
Flags
Writeback
Review trigger
New lab panel has 32 markers. Seven are out of range and require reviewer classification before the member record goes live.
Reviewer summary
Most markers are normal or optimal. ApoB is the primary flagged value and should be retained as a watch item for the next Health Brief.
| Marker | Status | Value | Review |
|---|---|---|---|
| Fasting Glucose | Optimal | 88 mg/dL | Approve |
| HbA1c | Normal | 5.4% | Approve |
| Fasting Insulin | Optimal | 4.2 μIU/mL | Approve |
| ApoB | Out of range | 108 mg/dL | Flag for note |
| hs-CRP | Optimal | 0.6 mg/L | Approve |
System output
Approved markers will update the member record, flagged values will be retained for the clinical note, and the data will feed the next Health Brief.Needs approval
Approval writes the biomarker set to James Carter’s member record, retains flagged items for clinical note, and makes the data available for the next Health Brief.