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HEALTHCARE AI AGENTS

Five specialized agents working together to transform member outcomes and reduce costs.

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ENGAGE — Member Risk Intelligence

Risk Scoring — AI analyzes claims, demographics, social determinants, and engagement history to generate 0-100 risk scores for every member. Identifies isolation, crisis, and chronic escalation risk.

Smart Outreach — Recommends optimal contact channel (call, SMS, email), best time-of-day, and personalized talking points for each member based on their profile and history.

Intervention Planning — Auto-generates intervention recommendations: wellness checks, care coordinator referrals, behavioral health follow-ups, medication adherence programs.

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VOICE — Call QA Automation

Transcript Analysis — Summarizes every call in seconds. Extracts key topics, member sentiment, action items, and follow-up requirements. No more manual call reviews.

QA Scoring — Scores agent performance on empathy, accuracy, protocol adherence, and resolution quality. Generates coaching recommendations for each agent.

HIPAA Compliance — Detects PHI disclosure violations, consent gaps, and regulatory red flags in real-time. Flags calls for compliance review automatically.

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PULSE — Outreach Optimization

Campaign Intelligence — A/B test suggestions for messaging, subject lines, and CTAs. Segment-specific personalization that increases response rates by 3x.

Channel Ranking — Ranks outreach channels (call, SMS, email, mail) by predicted effectiveness for each member segment. Optimizes send times down to the hour.

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PREDICT — Health Outcome Forecasting

ER Visit Prediction — Identifies members heading toward emergency room visits 30-90 days in advance. Early intervention prevents costly acute episodes.

Cost Projection — Forecasts per-member and population-level healthcare costs. Quantifies ROI of preventive interventions before you invest.

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CODE — Pipeline Guardian

ETL Monitoring — Watches your data pipelines 24/7. Detects errors, schema drift, missing records, and data quality issues before they impact operations.

Auto-Healing — Suggests automated fixes for common pipeline failures. Keeps member data flowing clean between EHR, claims, and engagement platforms.

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SCOUT — Infrastructure Audit

24+ Resource Types, 100+ Checks — Scans SQL, NSGs, storage, AKS, Redis, Event Hubs, Service Bus, Cosmos DB, PostgreSQL, MySQL, Synapse, Key Vaults, Firewalls, Load Balancers, App Gateways, and more. Now includes managed identity checks, Network Watcher, JIT access, NSG flow logs, resource locks, storage firewalls, and SQL advanced security.

0-100 Risk Scoring — Every finding gets a numeric risk score (severity + blast radius + regulatory impact + exploitability). Environment risk rating: SECURE to CRITICAL. Handles 2,000+ findings at once.

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SENTINEL — Penetration Testing

50+ Pen Test Checks — Simulates RDP brute force, SQL injection, data exfiltration, AKS pod escape, Elasticsearch exploits, LB traffic interception. NEW: VNet peering misconfigs, Key Vault secret expiry, custom role privilege escalation, service principal audits.

Cross-Agent Intelligence — Ingests Scout findings for prioritized testing. Critical findings get tested first. HIPAA/HITRUST/SOC2/CIS compliance verification with 14 CIS controls.

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FORGE — optional remediation (opt-in)

125+ Auto-Fixes, 97% Remediation — 28 fix methods covering all resource types. Auto-fixes: Cosmos DB, PostgreSQL, MySQL, Databricks (10 checks), managed identity, diagnostic settings, Microsoft Defender (11 types), Network Watcher auto-creation, resource locks, Azure Firewall threat intel, App Gateway WAF + SSL policy.

Learning Engine — Forge learns from every fix outcome. False positive feedback auto-adjusts thresholds. Preview mode shows exactly what will change before any modification. Verification re-scan confirms all fixes.

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COMPLY — Compliance Mapping

9 Frameworks, 247 Controls — SOC 2, HIPAA, HITRUST CSF v11, PCI-DSS v4.0, ISO 27001:2022, NIST 800-53 Rev 5, FedRAMP, CMMC 2.0, DORA — cross-mapped. PASS/FAIL/CHECK per control.

Executive-Ready Reports — The TITAN AI engine generates compliance narratives with evidence. Prioritized remediation roadmap. Pipeline orchestrates all 5 agents with parallel execution and 2,000+ finding capacity.

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SHADOW — Exposure Intelligence Scanner

Shadow AI Detection (90+ Tools) — Scans Azure AD sign-in logs, app registrations, and network traffic for unauthorized AI tool usage. Tracks ChatGPT, Claude, Gemini, Copilot, Midjourney, Jasper, and 84 more across 16 categories. No competitor detects all of these.

Non-Human Identity Audit — Audits all service principals, managed identities, and app registrations. Detects expired credentials, over-privileged Owner/Contributor roles, and orphaned machine identities. 446 NHI entries scanned per environment.

Data Leakage + License Waste — Finds public blob containers, unencrypted databases, open firewall rules. Detects unused licenses, orphaned disks/NICs/IPs with monthly cost estimates. 30 compliance controls across HIPAA, SOC2, PCI-DSS, NIST.

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WATCH — Alert Monitoring & Email Reports

14 Monitoring Checks, 3 Auto-Fix Actions — Scans Azure Monitor alerts, metric/log alert rules, action groups, resource health, service health, activity log alerts, App Insights smart detection. Enforce mode auto-creates missing CPU, availability, and DTU alert rules.

Multi-Platform + Email Reports — Connects to Azure Monitor, Datadog, and Application Insights. Generates HTML email reports with severity breakdown. Sends via SMTP or Azure Communication Services. 24/7 automated client notifications.

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