How Carrie works
From provider intent to closed care loop, automatically.
When a provider decides what a patient needs next (a discharge, a new prescription, a referral), Carrie makes sure it actually happens. Here's the whole loop, in depth.
"It was comforting to know I could call her any time of day."
Patient, dermatology pilot
A provider signs an order. A discharge, a new prescription, a referral. That signature is the trigger; nobody builds a call list.
Carrie enrolls the patient automatically. The order tells her who, why, and on what schedule.
She calls. By phone, in the patient's own language. No app, no login, no portal.
She listens and classifies. Symptoms, missed medications, and barriers like transportation become clear signals for the care team.
She acts or escalates. She educates and guides, or hands the care team a ready-to-act summary.
The evidence is saved. Written into the patient's medical record. The EHR (the electronic health record) stays the source of truth.
Five actions, one conversation.
Carrie reaches out first, on the schedule the provider's order sets. Portals wait for a login that 40%+ of patients never make.2
Carrie has real two-way phone conversations, in the patient's own words and language. Broadcast messages hear nothing back.
New symptoms, missed medications, and barriers like transportation become clear signals. Monitoring devices send numbers without the story.
Carrie educates, guides, or escalates with summaries that care teams can act on immediately. Nothing waits in a voicemail queue.
Every conversation informs the next, across months and conditions. Triage lines start from zero every time.
The integration ecosystem.
These connections run on the FHIR Connect Engine, our integration layer built on FHIR, the data standard modern health records speak. Upstream it reads provider intent and patient context out of the record. Downstream it turns decisions into actions and writes the evidence back. One engine, so a new EHR or a new data source is a connection, and every Program that exists can use it immediately.
Upstream · tells Carrie the patient's whole story
| Electronic health records | the patient's chart and history |
| Remote monitoring devices | scales, blood pressure cuffs, glucose monitors at home |
| Labs & diagnostics | test results, as they land |
| Social & demographic context | language, transportation, coverage |
| Medical knowledge bases | the clinical guidelines care Programs draw on |
Downstream · lets her get things done
| Practice workflows & clinical oversight | the queue your team reviews and acts on |
| Pharmacy & prescriptions | refills picked up, or flagged when they aren't |
| Scheduling | visits booked, moved, and recovered |
| Transportation to appointments | rides arranged when getting there is the barrier |
| Home health & medical equipment | services and supplies at home |
| Quality reporting | the measures programs are graded on |
The EHR owns the record. Carrie carries the relationship.
Programs: the playbooks Carrie runs.
What a Program is
A pre-built playbook for one condition or workflow, written and approved by clinicians and versioned like software. Released versions are immutable: no edits after release, so every call runs on a known, reviewable version.
Programs run together
Several Programs run at once for the same patient, mutually aware. What one Program hears informs the others, and one conversation covers all of them. A symptom mentioned in passing lands wherever it matters.
Written by specialists, versioned like software.
Each Program is authored by the specialists who treat the condition: the heart-failure Program by cardiologists, the chemotherapy Program by oncologists, the diabetes Program by endocrinologists. It encodes the questions they'd ask, in the order they'd ask them, and what should happen with each answer. Changes go through review and release, and every released version is immutable.
Why Carrie runs on Programs.
An improvising model gives you its best guess in the moment, and tomorrow's best guess may differ. A Program can be printed, read, and signed off before a single patient is called. Afterward, every call can be replayed against the exact version and logic it ran. Ask why Carrie said something and you get the Program version, the line of logic, and the recording. That's what makes AI safe to run at this scale: providers stay in command of what it says, and audit is built into the system itself.
Governed like a clinical service.
The parallel safety agent
A second, independent AI checks every sentence of every call in real time for emergencies, separate from the AI doing the talking.
Four-color flagging, human oversight
Every concern is graded on a four-color scale and verified by the Human Oversight Team, licensed clinicians who confirm urgent flags within 1 hour. Escalations arrive as an SBAR, the structured handoff clinicians already use: Situation, Background, Assessment, Recommendation.
Immutable audit log
Every conversation is recorded in full and can be replayed exactly, an audit log that can't be edited after the fact.
Carrie never diagnoses, prescribes, or places orders; clinical judgment stays with the care team.
This is what care orchestration looks like when it's governed: a provider signs an order, and a specialist-written Program carries that intent to the patient, at whatever scale the panel demands.