# description
Comprehensive baseline physiologic assessment. Assessment-day choreography (intake through same-day physiology debrief) followed by a Results Synthesis visit at day 7-10. Results are released only through physician framing; the Benchmark Report is a physician-signed artifact.

# purpose
Establish a longitudinal physiologic baseline across the seven Benchmark pillars and deliver physician-framed results via the two-touch architecture.

# usage
Apply to a Patient at Benchmark scheduling via PlanDefinition/$apply to generate the RequestGroup and Tasks for the assessment day and follow-up visit.

# action[].description
Member completes medical history, PAR-Q+/exercise readiness screening, informed consent, and goals questionnaire prior to assessment day.

# action[].description
Arrival check-in, resting vitals (BP, HR, SpO2, height, weight), and fasting blood draw covering the full Benchmark biomarker panel. Specimens routed to reference lab via Health Gorilla.

# action[].action[].description
CBC with differential, ferritin, iron and iron-binding capacity.

# action[].action[].code[].coding[].display
Ferritin [Mass/volume] in Serum or Plasma

# action[].action[].description
Comprehensive metabolic panel, HbA1c, fasting insulin, uric acid, urine albumin/creatinine ratio.

# action[].action[].code[].coding[].display
Comprehensive metabolic 2000 panel - Serum or Plasma

# action[].action[].code[].coding[].display
Insulin [Units/volume] in Serum or Plasma --fasting

# action[].action[].code[].coding[].display
Microalbumin/Creatinine [Mass Ratio] in Urine

# action[].action[].description
Standard lipid panel, apolipoprotein B, lipoprotein(a), NT-proBNP.

# action[].action[].code[].coding[].display
Apolipoprotein B [Mass/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
Lipoprotein (a) [Mass/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
NT-proBNP [Mass/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
C reactive protein [Mass/volume] in Serum or Plasma by High sensitivity method

# action[].action[].code[].coding[].display
Homocysteine [Moles/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
Gamma glutamyl transferase [Enzymatic activity/volume] in Serum or Plasma

# action[].action[].description
TSH, free T4, total and free testosterone, estradiol, SHBG, IGF-1.

# action[].action[].code[].coding[].display
Thyrotropin [Units/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
Thyroxine (T4) free [Mass/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
Testosterone [Mass/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
Testosterone free [Mass/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
Estradiol (E2) [Mass/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
Sex hormone binding globulin [Moles/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
Insulin-like growth factor-I [Mass/volume] in Serum or Plasma

# action[].action[].description
25-hydroxyvitamin D, vitamin B12, folate, omega-3 index (RBC EPA+DHA).

# action[].action[].code[].coding[].display
25-Hydroxyvitamin D2+D3 [Mass/volume] in Serum or Plasma

# action[].action[].code[].coding[].display
Cobalamin (Vitamin B12) [Mass/volume] in Serum or Plasma

# action[].title
Physician History and Physical Examination

# action[].description
Comprehensive history and physical examination performed by the physician in the closed exam room.

# action[].description
GE Lunar iDXA whole-body scan capturing body composition (fat mass, lean/muscle mass, percentage body fat), CoreScan visceral adipose tissue quantification, and bone mineral density with T-scores. Results normalized to FHIR via DICOM-to-FHIR bot.

# action[].description
VALD ForceDecks battery: countermovement jump, isometric mid-thigh pull, and balance testing. Results ingested via VALD REST API.

# action[].description
Structured strength testing (grip strength, loaded movement screens) conducted in the open-floor strength assessment area.

# action[].description
COSMED Quark CPET with continuous gas exchange for VO2max, ventilatory thresholds, and exercise ECG. Performed last in the physiologic battery to avoid confounding prior measurements. Results normalized via HL7v2-to-FHIR bot.

# action[].description
On-site physician debrief of same-day physiologic results (CPET, iDXA, force plates). First touch of the two-touch results architecture. Lab results are NOT released at this visit; no results are released through the portal before physician framing.

# action[].title
Benchmark Report Generation and Physician Sign-Off

# action[].description
Compile the Benchmark Report from all resulted studies via the report generator. Physician reviews, frames, and signs. The signed report is the bound artifact delivered at the Results Synthesis visit.

# action[].description
Second touch of the two-touch architecture, scheduled 7-10 days after assessment day. Physician-led synthesis of the complete Benchmark including labs, delivery of the signed Benchmark Report, and longitudinal plan.