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Healthcare · Compliance readiness

Quality measure abstraction copilot, without the chart chase.

Extract measure evidence from structured and unstructured records, show the evidence span, and let abstractors adjudicate numerator, denominator, and exclusion status.

◆ human-gateda person approves every consequential action
$21,000
fixed-scope pilot
Specialist opportunity
launch posture
Strong durable demand
market signal
quality-measure-abstraction-copilot
// identify candidate evidence
input: Measure specification
step: retrieve exact measure logic
citations: [ source ✓ ]   confidence: 0.93
HUMAN GATEawaiting review →

Nothing is finalized until a human approves it.

Built for
The buyer
Chief Quality Officer, VP Clinical Quality, payer Quality executive
The champion
Quality Measurement Director, Clinical Informatics lead, HEDIS/eCQM manager
Day-to-day users
Nurse abstractors, quality analysts, registry teams

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.

Manual chart review is expensive, measure logic changes, evidence is distributed across notes and documents, and black-box abstraction is difficult to defend.

Who feels it

Nurse abstractors, quality analysts, registry teams

Trigger to act: Abstraction backlog threatens reporting deadlines, hybrid measures require chart chase, or measure audits expose inconsistent evidence trails.

Outcome & ROI

The result you can model before you sign.

Illustrative, replace with your data
$45,600
per month, illustrative

Illustrative only: 6,000 charts/year × 12 minutes removed × $38 loaded hourly cost ÷ 60 = $45,600 annual capacity, before audit-risk reduction.

The outcome, plainly: Extract measure evidence from structured and unstructured records, show the evidence span, and let abstractors adjudicate numerator, denominator, and exclusion status.

Abstraction agreement
evidence-span accuracy
charts per hour
How it works

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

A Document AI + grounded RAG copilot. Every material fact is grounded in an allowed source and returned with its identifier, no invented data.

01
Identify candidate evidence
02
retrieve exact measure logic
03
extract dates/values
04
map to numerator/denominator/exclusion
05
cite record spans
06
calculate confidence
07
queue adjudication
Reference architecturegrounded · human-in-the-loop · fully auditable
Source systems · scoped access
EHR / clinical data warehouse
Chart repository
Measure specification library
Quality platform
Audit work queue
Grounded reasoning core
Retrieve & extract
grounded on your sources, returns citations
Reason & draft
Claude Sonnet 4.6 or GPT-5.6 Terra
Human gateQualified abstractors adjudicate every reportable result and any conflicting evidence; the engine cannot silently infer absent documentation.
Action · only after approval
queue adjudication
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 evidence-aware extraction and reasoning; Gemini 2.5 Flash-Lite or Claude Haiku 4.5 for high-volume classification and normalization. Amazon Textract or Azure AI Document Intelligence; PostgreSQL + pgvector; Pinecone only when scale/latency requires it.

Inputs
  • Measure specification
  • Patient cohort
  • Encounters
  • Labs
  • Medications
  • Clinical notes
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

Qualified abstractors adjudicate every reportable result and any conflicting evidence; the engine cannot silently infer absent documentation.

What it will never do
No autonomous certified reporting
No substitution for licensed measure specifications
No inference of absent clinical facts
No mixing measure versions without explicit controls
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
Abstraction agreement
Evidence-span accuracy
Charts per hour
False inclusion/exclusion
Audit overturns
Unresolved-case rate
Specification regression pass rate
Why this, not that

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

The alternatives
InovalonCotivitiReveleerHealth CatalystArcadiaInternal quality abstraction vendors
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.

EHR / clinical data warehouseChart repositoryMeasure specification libraryQuality platformAudit work queue
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
$21,000
one-time · bounded proof of value
  • One process / scope
  • Live workflow on your data
  • Baseline evaluation suite
  • Measured vs. current process
Most chosen
Production
$49,000
one-time · full deployment
  • Full scope & integration
  • Human-review UI & audit trail
  • Write-back to your systems
  • Production evals & monitoring
Enterprise
$82,000
one-time · multi-entity / regulated
  • Multi-facility rollout
  • Advanced security & compliance
  • Custom control & escalation
  • Dedicated evaluation program
Monthly operating cost

8,000–30,000 pages per month plus retrieval, generation, vector search and evidence storage.

$1,100–6,800
usage (models, OCR, vector, storage)
$2,800/mo
managed evaluation & monitoring

Planning assumptions, not vendor quotations. Your EHR 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. Qualified abstractors adjudicate every reportable result and any conflicting evidence; the engine cannot silently infer absent documentation. The system drafts and recommends; a human approves every consequential action. Explicitly excluded: No autonomous certified reporting; no substitution for licensed measure specifications; no inference of absent clinical facts; no mixing measure versions without explicit controls..

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 $1,100–6,800/month (8,000–30,000 pages/month plus retrieval, generation, vector search and evidence storage), plus a $2,800/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 Inovalon?

Tools like Inovalon, Cotiviti, Reveleer 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 specialist opportunity. We baseline “Abstraction agreement” 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 Quality Measure Abstraction Copilot