Harold Baxter
Chronic Disease Management · Eligible · 76 yo · Medicaid ID MCD-120000015
Current Care Plan
Open Care Plan Copilot →Annual wellness visit overdue
Harold Baxter will complete his overdue annual wellness visit with his primary care physician within the next 30 days to ensure comprehensive management of his chronic conditions.
Assessment
Open Assessment Copilot →Comprehensive Reassessment — IN PROGRESS
Tasks, Alerts & Care Gaps
Workflow Orchestration
Rules + SLA engineRules fire only after a care manager approves something. Each item is routed to an owning team and given an SLA clock; anything past SLA escalates to the supervisor queue.
Automation history
- Care plan item approvedSep 16, 2026, 10:58 AM
- Contact Harold to schedule an appointment with his primary care physician → routed to Care Manager, due Sep 17, 2026Turn approved interventions into owned tasks · owner set by the rule that created it
- Provide reminders to Harold for his appointment → routed to Care Manager, due Sep 17, 2026Turn approved interventions into owned tasks · owner set by the rule that created it
- Ensure that all relevant health information is prepared for the visit → routed to Care Manager, due Sep 17, 2026Turn approved interventions into owned tasks · owner set by the rule that created it
- Send updated care plan to PCP and member → routed to Care Coordination, due Sep 19, 2026Distribute the updated care plan · owner set by the rule that created it
- Contact Harold to schedule an appointment with his primary care physician → routed to Care Manager, due Sep 17, 2026
- SLA breach sweepSep 15, 2026, 11:24 AM
- SLA breach: CHF weight gain flagged by remote monitoring → routed to Supervisor — Dana Whitfield, due Sep 15, 2026Escalate on SLA breach · escalations route to the supervisor queue
- SLA breach: Annual wellness visit overdue → routed to Supervisor — Dana Whitfield, due Sep 15, 2026Escalate on SLA breach · escalations route to the supervisor queue
- SLA breach: CHF weight gain flagged by remote monitoring → routed to Supervisor — Dana Whitfield, due Sep 15, 2026
Active rules (7) — configuration, not code
- Transmit assessment + care plan to PCPAssessment completed
The completed assessment and care plan have to reach the PCP; today that is a manually generated letter.
- Reset the reassessment clockAssessment completed
Completing a reassessment books the next one and moves the case due date out, instead of leaving it on a spreadsheet.
- Behavioral health co-management reviewAssessment completed
Co-managed behavioral health cases get a second reviewer rather than routing everything back to the primary CM.
- Turn approved interventions into owned tasksCare plan item approved
Each intervention on an approved care plan item becomes a routed, SLA-tracked task rather than free text inside a PDF.
- Distribute the updated care planCare plan item approved
An approved change to the care plan triggers distribution to the PCP and the member.
- Supervisor review on escalationAI suggestion approved
An approved escalation opens a short-SLA supervisor review instead of relying on someone noticing it.
- Care gap outreach on high-risk membersAI suggestion approved
An approved care gap on a high-risk member schedules member outreach so the gap has an owner and a clock.
Notes → Actions
No notes yet.
Timeline
CARE GAP: Annual wellness visit overdue
ESCALATION: CHF weight gain flagged by remote monitoring
Case opened in CCA
Claim received — office visit, evaluation & management
Prescription fill recorded
ESCALATION: SLA breach: CHF weight gain flagged by remote monitoring
ESCALATION: SLA breach: Annual wellness visit overdue
TASK: Contact Harold to schedule an appointment with his primary care physician
TASK: Provide reminders to Harold for his appointment
TASK: Ensure that all relevant health information is prepared for the visit
TASK: Send updated care plan to PCP and member