01Launch agent
Metabolic health follow-through, coordinated between visits.
The supervised Metabolic Health Agent reads each patient's longitudinal record and runs doctor-designed, medically-vetted protocols between visits — tracking monitoring signals, nudging adherence, collecting context, and escalating risk to a named clinician for review. It turns missed reviews, lapsed refills, and uncaptured RPM time into recaptured follow-ups and billable encounters, and logs every action it takes.
Patient 8042Longitudinal record
Encounters, labs, messages, care plans, adherence state, signals, tasks, consent, and escalation history.
02Who it is for
Chronic care teams that need care plans to survive the home setting.
Built for diabetes, hypertension, obesity, metabolic health programs, and teams coordinating monitoring, education, adherence, and follow-up.
- Patient activation
- Retention
- Care plan adherence
- Follow-up completion
- Care-team workload reduction
Each outcome carries a commercial edge: higher follow-up completion means recovered billable encounters, care-team workload reduction returns coordinator hours to top-of-license work, and better adherence means fewer avoidable escalations and readmissions.
03Operating detail
What the agent reads, does, escalates, and logs.
The agent runs doctor-designed, medically-vetted metabolic protocols and supports coordination only. It does not make independent diagnoses, unsupervised clinical decisions, or unsupported medical advice, and every action is logged for clinician review.
04Where the journey breaks
Metabolic care leaks between visits — for the patient and the program.
A patient leaves the clinic with a plan. At home, monitoring drops, refills lapse, the quarterly review slips, and the overdue HbA1c lab never gets booked. By the next visit the care team is seeing risk too late — and the program has quietly lost billable follow-up time it will never recover. The supervised agent watches that gap continuously and acts on it.
Missed and overdue reviews
Quarterly metabolic reviews and overdue labs slip silently between visits. The agent flags patients who are due or overdue and drives the follow-up — recovering encounters the program would otherwise have lost.
Uncaptured RPM & CCM time
Remote monitoring and chronic-care management minutes go unlogged when nobody is coordinating between visits. The agent collects context and logs activity so eligible RPM/CCM encounters are recaptured, not left on the table.
Lapsed adherence & no-shows
Lapsed refills, missed nudges, and no-shows turn into avoidable escalations and readmissions. Closing those gaps keeps patients on plan and returns coordinator hours to top-of-license work.
Every recovered review, refill, and monitoring window is a billable follow-up the program would have lost. Actual recoverable revenue is mapped to your data in the Patient Care Journey Audit.
Independent diagnosis
Medical judgment and clinical decisions remain with the care team.
Unsupervised clinical decisions
Risk-bearing decisions route to humans with context and history.
Unsupported medical advice
Education prompts must be approved and appropriate to the configured journey.
05Care journey audit
Start with a metabolic health care journey audit.
We audit your metabolic care journey end to end — mapping where reviews, refills, labs, and RPM minutes drop off between visits, and how much recoverable follow-up revenue and how many recaptured billable encounters a supervised, doctor-designed agent can return.