AN Alpesh Nakrani
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Healthcare · Growth

Care gap outreach that closes gaps without more staff hours.

Prioritize open care gaps, personalize compliant outreach, book eligible services, and route clinical barriers to care teams.

◆ human-gateda person approves every consequential action
$16,500
fixed-scope pilot
Validate next
launch posture
Strong durable demand
market signal
care-gap-outreach-agent
// validate gap eligibility
input: Attributed population
step: prioritize cohorts
citations: [ source ✓ ]   confidence: 0.93
HUMAN GATEawaiting review →

Nothing is finalized until a human approves it.

Built for
The buyer
Chief Population Health Officer, payer or ACO COO, VP Quality
The champion
Population Health Director, Care Management leader, Quality Improvement lead
Day-to-day users
Care coordinators, outreach teams, primary-care practices, members/patients

Designed, built, and evaluated by Alpesh Nakrani, VP of Growth at ViitorCloud, 14 years shipping software, writing on AI-Native engineering and evaluation.

Evals-first
built in from day one
Human-gated
judgment stays with you
The problem

Where the time and money actually go.

Static call lists create low contact rates, generic messages, duplicate outreach, and weak visibility into why patients do not complete preventive or chronic-care actions.

Who feels it

Care coordinators, outreach teams, primary-care practices, members/patients

Trigger to act: Quality targets are off track, outreach capacity is constrained, or an ACO/payer needs a repeatable campaign engine with evidence and consent controls.

Outcome & ROI

The result you can model before you sign.

Illustrative, replace with your data
$12,000
per month, illustrative

Illustrative only: 5,000 eligible patients × 2 percentage-point incremental closure × $120 internal value per completed action = $12,000 program value. The buyer must define the defensible value per closure.

The outcome, plainly: Prioritize open care gaps, personalize compliant outreach, book eligible services, and route clinical barriers to care teams.

Gap closure rate
contact rate
appointment conversion
How it works

Inputs in. A cited, review-ready result out. Your expert decides.

A Tool-using workflow agent. Every material fact is grounded in an allowed source and returned with its identifier, no invented data.

01
Validate gap eligibility
02
prioritize cohorts
03
select channel and message
04
conduct outreach
05
answer approved logistics questions
06
schedule
07
document barrier
08
route exceptions
Reference architecturegrounded · human-in-the-loop · fully auditable
Source systems · scoped access
Population health platform
EHR
CRM/contact center
scheduling
consent/preferences
Grounded reasoning core
Retrieve & extract
grounded on your sources, returns citations
Reason & draft
Claude Sonnet 4.6 or GPT-5.6 Terra
Human gateClinical advice, ambiguous exclusions, vulnerable-patient situations, and repeated nonresponse follow client-approved escalation and human review protocols.
Action · only after approval
route exceptions
Audit trace
sources, rules, confidence, reviewer
Tenant isolation
minimum data, never cross-tenant
Evaluation suite
baselined pre-launch, watched after
Observability
cost, latency & drift telemetry
Model strategy

Claude Sonnet 4.6 or GPT-5.6 Terra for complex grounded work; select by task-level evaluation; Gemini 2.5 Flash, GPT-5.4 mini or Claude Haiku 4.5 for high-volume routing and drafting. PostgreSQL + pgvector or managed vector store; Policy rules and evaluator service.

Inputs
  • Attributed population
  • open gap
  • eligibility and exclusion rules
  • contact preference
  • language
  • appointment supply
The human gate

AI-Native, not autonomous. Judgment stays with your people.

The machine does the work; the human’s role narrows to the one thing that matters, judgment. That constraint is what makes it safe to deploy.

Non-negotiable human gate

Clinical advice, ambiguous exclusions, vulnerable-patient situations, and repeated nonresponse follow client-approved escalation and human review protocols.

What it will never do
No coercive outreach
no clinical recommendation beyond approved content
no contacting patients without consent/legal basis
no guarantee of quality bonus attainment.
The scorecard

A scorecard, not a demo. We baseline what breaks in production.

Every deployment ships with an evaluation suite. These are the numbers we baseline before launch and monitor after.

Primary
Gap closure rate
contact rate
appointment conversion
opt-out/complaint rate
duplicate outreach
false-gap rate
cost per closed gap
equity by segment
Why this, not that

The category is crowded. Most of it isn’t built for your workflow.

The alternatives
InnovaccerArcadiaHealth CatalystLumerisArteraIcarioEHR population-health modules
This implementation

Fixed-scope, tuned to your systems and rules, grounded in your data, with the human gate and audit trail built in from day one. A price you own, not a subscription you rent.

✓ Fixed price, not a seat subscription ✓ Grounded in your data & rules ✓ Human approval on consequential actions ✓ Auditable decision trace
Systems & integrations

It plugs into the stack you already run.

No rip-and-replace. Access is scoped to the minimum data necessary, isolated per tenant, and fully logged.

Population health platformEHRCRM/contact centerschedulingconsent/preferencesquality-measure logicsecure messaging/telephony
Pricing

Transparent by design. The build price buys the workflow and the proof.

A fixed implementation fee plus a monthly bill that scales with volume and governance. No hidden seats.

Pilot
$16,500
one-time · bounded proof of value
  • One process / scope
  • Live workflow on your data
  • Baseline evaluation suite
  • Measured vs. current process
Most chosen
Production
$38,000
one-time · full deployment
  • Full scope & integration
  • Human-review UI & audit trail
  • Write-back to your systems
  • Production evals & monitoring
Enterprise
$63,000
one-time · multi-entity / regulated
  • Multi-facility rollout
  • Advanced security & compliance
  • Custom control & escalation
  • Dedicated evaluation program
Monthly operating cost

10,000–35,000 workflow runs/month with modest document and model usage.

$400–3,100
usage (models, OCR, vector, storage)
$2,600/mo
managed evaluation & monitoring

Planning assumptions, not vendor quotations. Your Population health platform and other platform licenses are separate and owned by you. Figures confirmed during scoping.

On working with Alpesh
“His vast knowledge of technologies and a natural problem-solving mindset consistently lead us through complex challenges with clarity and confidence.”
AM
Adil Multani
Senior Backend Developer
Why this is safe to try
01Baseline first. We measure your current numbers before we build anything.
02Fixed scope, fixed price. One process in the pilot. No open-ended engagement.
03Expand only if the scorecard earns it. You see the measured result before committing to production.
04Your people stay in control. The human gate means nothing consequential happens without a human’s approval.
FAQ

Questions serious buyers ask.

Does the AI act on its own?

No. Clinical advice, ambiguous exclusions, vulnerable-patient situations, and repeated nonresponse follow client-approved escalation and human review protocols. The system drafts and recommends; a human approves every consequential action. Explicitly excluded: No coercive outreach; no clinical recommendation beyond approved content; no contacting patients without consent/legal basis; no guarantee of quality bonus attainment..

How do you stop it inventing facts?

Every material claim is grounded in an allowed source record and returned with its source identifier. The system separates observed facts, model inference, and missing information, and routes to a human whenever confidence is low, evidence conflicts, or an adverse outcome is possible.

What does it cost to run each month?

A usage bill of roughly $400–3,100/month (10,000–35,000 workflow runs/month with modest document and model usage), plus a $2,600/month managed retainer for evaluation, monitoring and maintenance. Your existing platform licenses are separate and already yours. Exact figures are confirmed during scoping.

Do we need a ChatGPT or Claude subscription?

No consumer ChatGPT or Claude subscription is required for the production workflow. The client needs an approved API/cloud billing account. Workspace seats are optional for internal prototyping and administrator access.

How is this different from Innovaccer?

Tools like Innovaccer, Arcadia, Health Catalyst are broad platforms you adapt to. This is a fixed-scope implementation tuned to your systems and rules, grounded in your data, with the human gate and audit trail built in, and a transparent price instead of a seat subscription.

How long until it’s live, and how do we prove it works?

This is a validate next. We baseline “Gap closure rate” first, then measure against that baseline. You see the scorecard before expanding scope, the evaluation suite ships with the system, not as an afterthought.

Book a scoping call

Bring your real numbers. Leave with a fixed-scope plan.

A 30-minute engineering-led working session, no slideware. You leave with a sized opportunity estimate, a fixed-scope pilot plan, and the integration & human-review path mapped.

VP of Growth at ViitorCloud · senior delivery owner confirmed before paid work

Ask AI about Care Gap Outreach Agent