Care Gap AI: Identifying Patients Before They Fall Through
Program-led AI capabilities that identify at-risk patients and automate outreach.
Role: Technical Program Manager
Business Problem
myPCT needed to move from a transactional platform to proactive care — identifying patients with open care gaps and closing them through timely outreach, without overwhelming a lean clinical team.
Architecture
A capability set layered on the platform: Care Gap (AI-driven patient identification), LiverScan (clinical screening), and automated appointment scheduling and patient-call workflows — all governed within the existing program structure.
Technology
Delivery
Drove delivery of the new capabilities within the established WBS and JIRA governance, coordinating engineering, clinical consultants, and compliance officers.
Challenges
- Translating clinical intent into reliable identification logic.
- Automating outreach without compromising compliance.
- Sequencing AI capabilities behind core platform modules.
Solution
Program-managed the rollout of Care Gap identification, LiverScan screening, and automated scheduling/call workflows, integrating them into the platform's delivery cadence.
Business Outcome
- AI-driven patient identification for proactive care-gap closure.
- Automated scheduling and outreach reducing manual load.
- A repeatable pattern for shipping clinical-AI capabilities.
Lessons Learned
Clinical AI succeeds when governance and clinicians are in the loop from day one. The model is the easy part; the workflow and accountability are the product.
Future Roadmap
Expand risk models, close the loop with claims/readmission analytics, and measure realized care-gap closure rates.