Care Coordination
Clinical, operational, and financial complexity where patient outcomes, revenue, and compliance all intersect.
Inside this journey
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Customer Discovery
Align on desired outcomes (ED and readmission reductions), current care management workflows, data sources, and decision-makers.
Discovery Questions
Start Here: Who Are We Talking With?
- Who will be the primary sponsor and day-to-day champion for this care coordination initiative?
- How many full-time care managers (RNs, social workers, CHWs) are actively managing high‑risk panels today?
- Describe your current care management team structure and handoffs (who owns admission, discharge, follow-up, community referrals)?
- Which of the following best describes your accountability model for ED visits and readmissions?
- From your perspective, what's the single biggest priority for your team right now (pick one)?
What Would a Real Win Feel Like?
- Imagine ED visits and readmissions fell by 20% across your highest-risk cohort — what changes would that actually unlock for your team and organization?
- Which stakeholders would celebrate that result most loudly (and which would be skeptical)?
- How would your success be measured quantitatively? Select all metrics you’d expect us to track.
- How soon would you expect to see a meaningful signal from a pilot before you’d consider expanding it?
- If a pilot delivered the expected outcomes, what organizational changes or investments would you envision next?
Are We Just Accepting Preventable Deterioration?
- Which parts of your current workflows most often allow high‑risk patients to fall through the cracks?
- Can you walk me through a recent patient case where a preventable admission or ED visit occurred—what happened and who was involved?
- How long has that kind of lapse been recurring, and what attempts have you tried to stop it?
- Which process causes the most frustration for care managers in that scenario (timeliness, information gaps, competing priorities, tech usability, other)?
- If you had to name one operational change that would stop those slips tomorrow, what would it be?
The Data You Swear By (and the Data You’re Missing)
- If asked to produce a single, trusted risk score for a patient today, which data sources would you rely on?
- Which of these data feeds do you currently receive in near-real-time (within 24 hours)?
- How reliable is patient matching across your systems today (consistent MRN/HICN, partial matches, lots of duplicates)?
- Who in your organization owns data quality and integration (titles/teams)?
- Would you be able to provide a sample feed (de-identified or real) for a technical proof-of-concept within 30–60 days?
Who Moves the Needle Around Here?
- When a change requires new workflows or investment, who has final sign-off — and who needs to be convinced first?
- What committee or governance body oversees value-based care initiatives and data-sharing decisions?
- Have you previously approved pilots that required cross-departmental change (yes/no)? If yes, what made those successful?
- Who should be included in a 30‑minute executive briefing to secure pilot approval?
- What timelines are realistic for procurement and legal review in your organization (from SOW to signature)?
What Keeps Your Care Managers Awake at Night?
- Which task consumes most non-clinical time for care managers (documentation, data reconciliation, referrals, outreach, scheduling)?
- How do care managers currently prioritize their daily caseload — algorithm, manual triage, provider referral, or other?
- What would reduce burnout fastest: fewer patients, better tools, more training, clearer workflows, or something else?
- Tell us about a time a care manager felt powerless to prevent a poor outcome—what was missing?
- What kinds of role-based training or decision support have you tried — and which felt effective?
What Would Convince Finance to Invest?
- What evidence would change finance’s view of care management from a cost to an investable strategic capability?
- What baseline metrics (current ED/readmit rates, costs) can you share to help us size potential ROI?
- Which threshold would make a pilot 'successful' for your leadership (pick a primary outcome)?
- How comfortable would your finance team be sharing contract-level performance to support joint governance?
- What cadence and format of reporting do decision-makers prefer during a pilot (weekly dashboard, biweekly review, monthly executive summary)?
What Would Stop a Pilot Before It Starts?
- What single technical, legal, or operational requirement would immediately block you from running a pilot?
- Do you have any existing non-negotiable privacy or data residency rules we should know about?
- What internal approvals and approximate lead times are needed for data sharing and integrations?
- If we identified a security or compliance gap, who would be responsible for remediation and what is a realistic SLA?
- Are there any upcoming organizational events (merger, EHR migration, contract renewal) that could impact project timing?
If We Deliver One Quick Win, What Should It Be?
- If we guaranteed one measurable improvement in 90 days, which of the following would earn your team’s trust fastest?
- What minimal patient cohort size and inclusion criteria would you prefer for a focused pilot (e.g., top 250 high-risk by claims, recently discharged heart failure patients)?
- Who should be the pilot’s executive sponsor, operational lead, and technical owner (titles/names)?
- What would be an acceptable definition of ‘pilot success’ to move to production (be specific: metric, magnitude, timeline)?
- How would you like us to share early learnings and iterate—weekly huddles, embedded shadowing, or living dashboard?
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Solution Experience
Translate the customer’s context into a shared view of how the platform prevents deterioration and reduces utilization using real patient scenarios.
Experience Meetings
- Solution Experience Pre‑Work & Current State Confirmation
- Consequence & Opportunity Quantification
- Live Patient Scenario Workshop — Diagnosis → Proof → Validation
- Future State Definition, Acceptance Criteria & Measurement
- Decision & Next Steps — Pilot Design, Data Readiness & Governance
- Establish the measurement plan and baseline values to be used for pilot evaluation.
- Customer: Provide finance inputs (cost per admission, average length of stay, reimbursement impacts) and any additional utilization data.
- Seller: Produce a short cohort impact brief quantifying potential savings and utilization reduction scenarios.
- Seller/Customer: Schedule a follow up if any consequence assumptions require deeper validation.
- Re‑state Current State & Desired Future State (one sentence each)
- For each patient case, obtain explicit validation that the platform's intervention would prevent deterioration and reduce utilization.
- Identify and document any feature/configuration/integration gaps that block the proven future state.
- Create a short list of follow‑up data or stakeholder validations needed before pilot design.
- Seller: Deliver annotated scenario decks showing timeline, platform intervention points, and expected avoided events for each patient.
- Customer: Provide validation responses (agree/disagree) per scenario and any missing clinical context called out during the workshop.
- Seller: Log configuration or integration gaps and propose mitigation options for the next meeting.
- Recap Validated Outcomes from Scenarios
- Agree on a single operational future state sentence that all stakeholders accept.
- Define clear, measurable acceptance criteria and success signals with owners and data sources identified.
- Introductions & Meeting Objectives
- Seller: Produce a one‑page Future State & Measurement Plan including metric definitions and baseline numbers.
- Customer: Confirm metric owners and provide any additional data access needed for baseline validation.
- Seller: Prepare a short pilot success dashboard mock that will be used to report outcomes during the pilot.
- Customer: Deliver data access credentials/sample feeds and sign the pilot data‑sharing checklist.
- Executive Recap: Current State → Consequence → Future State
- Align and secure agreement on pilot scope, cohort, timeline and measurable targets.
- Confirm data‑feed readiness and assign integration/data owners with delivery dates.
- Obtain explicit go/no‑go decision or a defined path to sign‑off for the pilot.
- Seller: Produce a Pilot SOW, timeline, and roles matrix for customer review and signature.
- Seller & Customer: Schedule Pilot Kickoff meeting and identify milestone owners for deployment readiness.
- A single, agreed one‑sentence current state that all participants can repeat.
- A prioritized list of 3 patient scenarios and confirmed data extracts for each.
- A roster of validation stakeholders (clinical, operational, finance) who will attend scenario sessions.
- Customer: Deliver one‑sentence current state and anonymized data extracts for 3 patient scenarios by the agreed deadline.
- Customer: Provide list of invited validation stakeholders and their roles.
- Seller: Prepare a discovery summary and a scenario template mapping required fields to platform inputs.
- Recap One‑Sentence Current State
- Agree on baseline utilization and the quantified cost/operational consequences of the current state.
- Select prioritized cohorts for the Solution Experience and pilot candidate(s).
- Capture finance/clinical sign‑off on the consequence assumptions or identify items that need follow‑up.
- Patient Scenario A — Diagnosis (Timeline & Failure Points)
- Baseline Metrics Presentation
- Pilot Scope & Cohort Definition
- Draft One‑Sentence Future State
- One‑Sentence Current State Readback
- Map Consequence to Money/Time/Risk
- Define Acceptance Criteria & Success Signals
- Evidence Review: Workflows & Data Sources
- Data & Integration Readiness Review
- Patient Scenario A — Proof in Platform (Risk, Match, Workflow)
- Prioritize Patient Cohorts by Impact
- Patient Scenario A — Validation Check
- Governance, Privacy & Roles
- Assign Metric Owners & Governance
- Impact Owners & Decision Makers
- Patient Scenario B — Diagnosis & Proof
- Select & Define Patient Scenarios (Pre‑Work Confirmation)
- Measurement Plan & Baseline Confirmation
- Decision & Next Steps (Sign‑off Items)
- Finance & Clinical Validation Round
- Patient Scenario C — Edge Case & Community Services
- Pre‑work Checklist & Deadlines
- Consensus & Exceptions Log
- Immediate Next Validation Steps
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Solution Scope
Define integrations, risk stratification tuning, care plan and workflow modules, training, and measurable acceptance criteria.
Scope Configuration
- Integrate EHR Data Feeds
- Ingest and Normalize Claims Data
- Patient Identity Matching and Merging
- Deploy Risk Stratification Models
- Configure Care Plan Templates
- Activate Task Automation for Care Teams
- Enable Referral Management
- Launch Transitions-of-Care Alerting
- Deploy Patient Outreach (SMS/Voice/Email)
- Integrate Community Resource Directory
- Provision Role-Based User Access
- Deploy Outcome Tracking and Value-Based Care Dashboards
Scope Questions
Integrate EHR Data Feeds
- Do you require real-time (ADT/FHIR) feeds, near‑real‑time, or daily/batch ingest for EHR data?
- Which EHR vendors and number of unique instances/sites should be integrated?
- What clinical data domains must be ingested (select all that apply)?
- Which exchange standards or interfaces are preferred/available (e.g., FHIR, HL7v2 ADT, CCDA, bespoke API)?
- Do you have existing integration endpoints or an integration partner (e.g., HIE, middleware)? If yes, list contacts and endpoints.
- What is the expected daily patient/event volume for EHR feeds (estimate)
- Are there environment requirements (sandbox/test instance, PHI controls, IP allowlists) or go/no-go security checks we should plan for?
Ingest and Normalize Claims Data
- Which types of claims do you need ingested (select all that apply)?
- What formats and frequency are your claims files (e.g., 837/EDI, adjudicated extracts, monthly feeder)?
- Do you have a preferred claims normalization/terminology standard (e.g., CPT/HCPCS mapping, NPI handling, standardized diagnosis mapping)?
- What is your expected monthly claims volume (number of claims lines)?
- Are there payer-specific business rules or adjudication fields we must preserve or map?
- Do you require linkage between claims and clinical records for the same patient cohorts (describe matching strategy if known)?
- Do you need historical claims backfill and if so, how many months/years?
Patient Identity Matching and Merging
- Which data sources will be used for matching (select all that apply)?
- Do you prefer deterministic matching, probabilistic matching, or a hybrid approach?
- What acceptable match confidence threshold (e.g., % or score) do you want for automatic merges vs manual review?
- Do you require a manual reconciliation UI/workflow for duplicates and suspected merges?
- Are there specific identifiers to prioritize (e.g., MRN, SSN, DOB+Name+Address)?
- Do patient consent/privacy rules affect the ability to merge or share records across systems?
- What is your current duplicate rate or known identity match error rate (estimate)?
Deploy Risk Stratification Models
- Which risk models do you plan to deploy (select all that apply)?
- Would you like to use our out-of-the-box models, have them tuned to your data, or build custom models?
- Do you have labeled historical outcomes (e.g., readmissions, ED visits) to support calibration and validation?
- What cadence is required for risk scoring (real-time on event, nightly batch, weekly)?
- Which performance metrics are required for acceptance (AUC, calibration, PPV/NPV, lift)?
- Are there population cohorts or segmentation rules (e.g., Medicaid, dual-eligibles, COPD) for which separate models are needed?
- Who will own model governance and periodic maintenance (data science team, vendor, joint)?
Configure Care Plan Templates
- Which clinical conditions or cohorts need templated care plans (select all that apply)?
- What components must each care plan include (goals, tasks, education, SDOH interventions, referral actions)?
- Do care plans need role-based task assignments and escalation rules?
- Should care plans be patient-facing (patient portal or printable summaries)?
- Do you require localized language/reading-level variants for patient materials?
- Will care plan templates require clinical governance approval/versioning workflows before publishing?
- Do you want templates mapped to billing or quality measure codes for reporting?
Activate Task Automation for Care Teams
- Which triggers should create automated tasks (select up to all that apply)?
- How should tasks be routed (role-based, named user, team queue, round-robin)?
- What SLA or expected resolution times should be enforced for critical task types?
- Are notifications for new/overdue tasks required via email, in-app, SMS, or EHR inbox?
- Do you require audit trails and reporting on task completion, reassignment, and outcomes?
- Should tasks be able to create follow-up tasks automatically (chained workflows)?
- Will task automation need to integrate with external systems (EHR tasks, telephony, scheduling)? If yes, list systems.
Enable Referral Management
- Do you track both internal and external referrals today or only internal?
- What referral statuses and lifecycle steps should be supported (e.g., requested, accepted, scheduled, completed)?
- Do you require automatic matching to providers based on specialty, insurance, geography, or network status?
- Should referral outcomes feed into outcome dashboards (e.g., referral completed, no-show, service provided)?
- Do you have an existing provider directory to integrate or do you need one provisioned/curated?
- Are authorizations/pre-certifications part of the referral workflow that must be tracked?
- Do you require patient-facing referral notifications and scheduling coordination (two-way communication)?
Launch Transitions-of-Care Alerting
- Which transition events should generate alerts (select all that apply)?
- What is the maximum acceptable latency for alerts from event to care-team notification?
- What feed source will provide transition events (HIE ADT, hospital EHR ADT, claims/encounter feed)?
- Who should receive alerts and how (care manager, primary care partner, team inbox, escalation list)?
- What key data elements must be included in each alert (meds on discharge, discharge diagnosis, follow-up appointment info)?
- Do you require automatic task creation or care plan changes triggered by transitions?
- Are there consent or privacy constraints for alert distribution across organizations?
Deploy Patient Outreach (SMS/Voice/Email)
- Which outreach channels do you want to enable (select all that apply)?
- Do you have consent/opt-in rules and language preferences to enforce for outreach?
- Is two-way/respondable messaging required (patient can reply and messages route to care team)?
- What message volume and peak throughput should we plan for (messages/month)?
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Mutual Commit
Finalize commercial terms, data‑sharing and privacy requirements, success metrics, and governance for outcome accountability.
Agreement Modules
- Non-Disclosure Agreement (NDA)
- Master Services Agreement (MSA)
- Statement of Work (SOW)
- Commercial Terms & Pricing Schedule
- Payment Schedule & Billing Terms
- Business Associate Agreement (BAA)
- Data Use / Data Sharing Agreement (DUA/DSA)
- Data Processing Agreement (DPA) & Privacy Addendum
- Security & Compliance Exhibit
- Governance & Success Metrics Charter
- Outcomes-Based / Risk-Sharing Addendum
- Acceptance Criteria & Go‑Live Signoff
- Implementation Schedule & Milestone Signoff
- Change Order & Scope Management
- Termination, Offboarding & Data Return Plan
- Third‑Party Integrations & API Access Agreement
- Patient Consent & Opt‑In/Opt‑Out Strategy
- Insurance, Indemnity & Liability Exhibit
- Training, Support & SLA Agreement
- Regulatory Attestation & Audit Rights
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Deployment
Operationalize rollout with readiness checks, enablement, and outcome validation.
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Pre-Deployment Readiness
Confirm data access, sample feeds, patient matching strategy, system owners, and HIPAA/security controls before build.
Readiness Questions
Start Here: Who You Are and What Success Looks Like
- What's your role and primary responsibility for care management outcomes?
- Are you accountable to value-based contracts that include financial risk for ED visits or readmissions?
- What specific ED or 30‑day readmission reduction targets have you been asked to deliver (give % or raw numbers)?
- Approximately how many attributed or high-risk patients does your team actively manage today?
- Which KPIs does your executive team use to judge care management success?
Are We Settling for Band‑Aids?
- What would it mean for your program if most avoidable hospitalizations are driven by fragmented data and handoffs—not clinical judgment?
- Describe your current transitions-of-care workflow from inpatient discharge to follow‑up—who does what and when?
- Which tools do care managers rely on daily to track patients and tasks?
- How often do care managers get actionable notifications (ED visit, discharge, high-risk event) in a timeframe that allows intervention?
- How does this current setup make your team feel—overwhelmed, reactive, proud, or something else? Share a short example.
Which Data Blind Spots Are Costing You Patients?
- If a single missing feed could prevent a cluster of avoidable readmissions, which feed would you bet on?
- Which of these data sources do you currently ingest into any system? Select all that apply.
- Can you provide a sample feed or example record today for one or more of those sources?
- What percentage of patient records reliably match across your systems with your current patient matching approach?
- Tell us about a recent patient who slipped through the cracks because of missing data or a matching error—what happened and what was the impact?
Who's Holding the Keys — and Will They Share Them?
- How likely is it that a critical system owner (EHR team, finance, legal, HIE) could block data-sharing required for deployment?
- List the key stakeholders and system owners we need buy‑in from (role, team, and how they influence the decision).
- What are the primary objections you typically hear from those stakeholders (security/privacy, cost, workflow disruption, ROI timeline, other)?
- Do you have an established data governance body, standard DSA/BAA templates, or specific legal requirements we must meet?
- What internal approval steps typically slow data-sharing decisions, and how long do those gates usually take (weeks/months)?
How Confident Are You in Your Risk Signals?
- How often do your 'highest-risk' lists produce false positives or miss patients who subsequently land in the ED?
- Which risk stratification approaches do you use today?
- Which performance metrics do you actively track for your models (AUC, PPV, recall, calibration, etc.)?
- Have you run local calibration or tuning of models for your population in the last 12 months?
- If provided a retrospective sample of risk scores, can you run validation against labeled outcomes (ED visits/readmissions) within your environment?
- How do you prioritize between reducing false positives (care manager burden) versus false negatives (missed patients)?
Imagine a Week Where No One Falls Through the Cracks
- If you could reduce avoidable ED visits by 25% in six months, what would be the single biggest change in your organization?
- Which patient cohorts would you prioritize for an initial pilot?
- Which success metrics would convince finance and leadership to scale the program?
- If the platform delivered consistent, actionable outreach lists and timely alerts, how would your care managers' day-to-day work change? Give one concrete example.
- Who would be your executive sponsor(s) for a successful pilot and how would they want to see early wins presented?
What Would Make Deployment Acceptable — Not Just Possible?
- What single security or privacy concern would cause you to halt a deployment the day before launch?
- Which certifications or security controls must we demonstrate before you can begin integration?
- Which integration methods do you prefer or require (select all that apply)?
- Who will own the day‑to‑day integration and vendor coordination on your side (IT, interoperability team, HIE, clinical ops)?
- For user acceptance testing (UAT), what sample patient volume and test cases would you expect to validate data fidelity and workflows?
Small Commitments That Unlock Progress
- Which of the following are you willing to commit to this quarter to materially reduce deployment friction?
- Who will serve as the primary point of contact for project coordination (name, role, email)?
- What is your ideal target date to begin a pilot?
- What preliminary acceptance criteria (numeric targets or process milestones) would make a pilot successful in your view?
- Are there any final concerns, blockers, or people we haven't asked about that could materially affect readiness?
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Deployment Enablement
Execute integrations, configure care models and workflows, deliver role-based training, and track milestone owners.
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Validation Checklist
Verify data fidelity, risk score calibration, workflow adoption, and baseline outcome measurements against acceptance criteria.
Validation Questions
Start Here: Tell Us Who You Are and What You Carry
- What's your title and the team you lead (brief)?
- Which best describes your organization type?
- Which populations are you mainly responsible for coordinating? (choose all that apply)
- Roughly how many patients are actively managed by your care teams today?
- What are the top three metrics leadership holds your team accountable for?
Are You Comfortable With 'Reactive' as Your Default?
- When an avoidable ED visit or readmission happens, who in your organization usually finds out first?
- How often does your team operate in firefighting mode (responding after events) rather than preventing them?
- Share a recent story where a patient 'fell through the cracks'—what happened, and what stopped you from intervening earlier?
- How does it feel for your staff when predictable escalations occur—demoralizing, expected, or motivating? Please explain briefly.
- If you had to name one part of your current process that perpetuates reactivity, what would it be?
Where Does Your Data Let You Down—and How Often?
- If your risk scores or alerts were 100% reliable tomorrow, what would your team stop doing?
- Which data sources do you currently ingest for risk stratification and care planning? (select all that apply)
- How timely are the critical feeds you depend on (e.g., ADT, claims, labs)?
- Tell us about your patient matching and deduplication—how confident are you that records represent the same patient across systems?
- Which single data gap keeps you from acting sooner on the patients who matter most?
Who Actually Owns a Patient’s Journey When Things Go Wrong?
- When outcomes are poor, who is held accountable by leadership?
- Describe the governance structure for cross-setting care (committees, cadences, veto rights). Who needs to sign off for changes?
- Who are the likely internal champions and the likely blockers for a platform that changes workflows?
- How do clinical teams prefer new workflows to be introduced—pilot teams first, dept-wide training, or top-down mandate?
- What decision criteria will your executive sponsors use to judge whether a new tool is worth the investment?
If You Could Eliminate One Costly Outcome Today, Which Would It Be?
- Which outcomes are highest priority for improvement in your contracts or internal goals? (select up to three)
- What are your current baseline rates or targets for those outcomes (attach numbers or describe trends)?
- How do you currently attribute reductions in utilization to care management activities? (e.g., standard ROI model, proxy measures, not attributed)
- What magnitude of reduction in ED visits/readmissions would make leadership sit up and approve continued funding?
- What non-financial signals (staff burnout, patient experience, provider relationships) matter most when judging success?
What Would Your Care Managers Do If They Had a Single Pane of Truth?
- If every relevant data point (claims, ADT, SDOH, last provider note) were visible in one view, what would your care managers stop asking for?
- Which workflows currently drain the most time from your care managers? (select all that apply)
- How do care managers prefer to receive tasks/alerts—email, EHR inbox, mobile app push, daily task board, or integrated workflow?
- Describe one workflow change that would free up the most clinical time for proactive outreach.
- What percent of your care managers' time is currently reactive (firefighting) versus proactive care coordination?
Are Your Risk Scores Telling the Truth—or Just Noise?
- How confident are you that your existing risk stratification identifies the right patients for intervention?
- Which inputs matter most to your risk models today (select all that apply)?
- How do you validate or calibrate risk scores—retrospective review, prospective pilot, or none?
- What false-positive or false-negative consequences are most painful (e.g., wasted CM time, missed high-risk patients)?
- If we proposed a re-tuning cadence for risk models, how often would you want to review and approve changes?
What Would Success Feel Like in 6 Months and in 18 Months?
- If we delivered a successful pilot, what specific metrics would you expect to see at 6 months?
- And at 18 months, what change would convince finance to expand investment?
- Which acceptance criteria are non-negotiable for you to sign off on go-live? (select all that apply)
- How will you measure sustained adoption after deployment—task completion rates, time-to-action, or user satisfaction?
- Which stakeholder will be the ultimate signatory that success has been achieved?
What Could Derail This Before You Even Start?
- What are the top technical or operational blockers you’ve seen kill similar initiatives in the past?
- How quickly can you provision a secure sample feed (ADT or claims) for a pilot?
- Which security or legal approvals tend to take the longest at your org (select all that apply)?
- Describe any previous integrations that failed—what specifically was the root cause?
- If integration, matching, or governance issues arise during pilot, what escalation path works best for you?
Who Needs to Be in the Room for This to Stick?
- List the people or roles who must be engaged for deployment and change management to succeed.
- Which groups will you want included in weekly pilot standups (select all that apply)?
- Who is most likely to push back on workflow changes, and what do they fear losing?
- Which clinical champions do you already have (names or roles), and how active are they?
- How would you like our team to partner on change management—train-the-trainer, co-led sessions, or turnkey support?
Let’s Get Practical: Your Next Concrete Step
- How ready is your org to start a pilot on a 3–6 month timeline?
- What pilot size would be meaningful but manageable (select one)?
- Are you willing to provide a secure sample feed and a named pilot champion for a quick validation?
- What would you like us to demonstrate first—data fidelity, risk tuning, or workflow prototype?
- Is there anything else that would help you decide to proceed after this discovery conversation?
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Success
Review outcomes versus agreed success signals, iterate care model and analytics, and maintain a shared channel for issues and enhancements.
Success Reviews
- Outcomes Review & Validation
- Care Model Iteration Workshop
- Analytics & Risk Model Calibration Session
- Shared Channel, Issue Triage & Enhancement Governance
- Quarterly Success Business Review (QBR)
Issues & Enhancements
- Provision the agreed shared channel and publish the triage form and SLAs.
- Produce a short test runbook to operationalize the pilot in the platform.
- Publish the pilot runbook (cohort definition, intervention details, success metrics) to the shared channel.
- Platform team to schedule configuration changes and deliver a sandbox preview before pilot start.
- Care management to nominate operational leads and training slots for pilot staff.
- One‑Sentence Current Model State
- Achieve a concrete calibration plan with measurable targets and a safe rollout approach.
- Ensure analytics changes are tied to operational impact and validated before production rollout.
- Define monitoring rules and SLA for model performance.
- Analytics team to deliver a back‑test report and recommended threshold with expected impact estimates.
- Set up a 14‑day shadow run and report template to evaluate proposed changes.
- Create automated alerts for drift thresholds and assign on‑call owners.
- Confirm Shared Channel & Access
- Create a single source for ongoing communication and a clear triage process for issues and enhancements.
- Assign operational and clinical owners with SLAs for common issue types.
- Agree on a predictable change control and release calendar to minimize disruption.
- Opening & One‑Sentence Current State
- Document RACI and escalation contacts and circulate to all stakeholders.
- Schedule standing weekly ops sync and monthly analytics review on calendars.
- Executive One‑Line Current State & Outcomes Snapshot
- Ensure executive alignment on whether agreed success signals justify acceptance, scale, or contract changes.
- Secure approvals or resources needed to scale successful interventions.
- Set prioritized roadmap and agreed metrics for the next quarter.
- Produce an executive one‑page scorecard with ROI estimates and distribute to finance and operations.
- If expansion approved, draft scope and timeline for scaling to additional cohorts or sites.
- Schedule the next QBR and confirm required pre‑reads (data pack, pilot results).
- Verify which agreed success signals are met, unmet, or partially met.
- Surface the primary root causes for any gaps between observed outcomes and targets.
- Validate interpretations through concrete patient scenarios (prove → validate).
- Decide immediate remediation or acceptance and assign owners and timelines.
- Deliver a outcomes evidence package (dashboard export, sample patient stories, data lineage) to attendees within 3 business days.
- Owner assignment for each unmet signal with remediation plan and due date.
- If accepted, prepare sign‑off document confirming success signals met and move to maintenance cadence.
- Recap Findings from Outcomes Review
- Convert outcome gaps into one prioritized pilot with clear hypothesis and measurable acceptance criteria.
- Align sellers, clinical leads, and operational owners on configuration changes and responsibilities.
- Re-state Agreed Success Signals
- Metrics Review (Calibration & Performance)
- Define Target Cohorts & Problem Statement
- Financial & Operational Impact
- Issue Triage Workflow & SLAs
- Successes, Risks & Open Items
- Change Control & Release Cadence
- Failure Mode Analysis
- Brainstorm Intervention Options
- Data Presentation: Outcomes vs Targets
- RACI for Escalations & Accountability
- Consequence Analysis
- Tuning Options & Tradeoffs
- Design Pilot/Test Plan
- Strategic Opportunities & Roadmap
- Case Review: Proof from Real Patients
- Decisions & Approvals
- Platform Configuration Walkthrough
- Recurring Maintenance Cadence
- Recalibration Plan & Validation
- Root Cause & Gap Diagnosis
- Monitoring & Alerting Specs
- Assign Owners & Timeline
- Summarize Actions & Next Review