Healthcare network · exploratory · ~65,000 staff · via the MedChefs relationship
The goal
Help staff sustain results and, where clinically appropriate, taper off GLP-1 without rebound, protecting both health outcomes and plan cost.
Why now: GLP-1 spend rose roughly 50% in 2025 and nearly half of users stop within a year, with significant weight regain after stopping. Durable behavior change is the lever, and coverage is increasingly gated on sustained engagement. The Epic / Sutter sync already in MedChefs is the integration path.
Orchestration
Signals in
GLP-1 adherence & side-effects
Nutrition & strength-activity logging
EHR via Epic / Sutter sync (BMI, labs, Rx)
Check-in affect
◆ Engagement cadence (the coverage-gate metric)
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The behavior-change layer
01 EvaluationDid support improve adherence, protect lean mass, and lower rebound risk? Measured against clinical targets.
02 ObservabilityAffect- and outcome-aware trace: the audit trail clinicians and compliance require.
03 Data FoundationAffective memory plus GLP-1 usage, adherence, and EHR context, co-defined with the clinical team.
04 OrchestrationPaige runs nutrition, strength, and side-effect coping; surfaces taper candidates to clinicians, never prescribing.
05 GovernanceHIPAA / PHI, HB 1806 licensed oversight; medication decisions stay clinician-owned.
Governance gate · HIPAA / PHI · HB 1806 licensed oversight · affect-gated
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Actions on surface
Lean-mass-protective activity nudge
Side-effect coping support
Rebound-risk flag
Taper-candidate list for clinicians
Engagement report for coverage
Human-in-the-loop: a clinician or pharmacist owns every medication and taper decision. The layer surfaces candidates, supports the behavior change, and flags rebound risk; it never prescribes.
Co-defined with the clinical and benefits teams: which signals safely indicate taper-readiness and rebound risk, and how engagement maps to the coverage requirement.