Annual preventive exams have been a staple of American medicine for decades. Yet despite their importance, preventive visits remain underutilized in American health care, which is no surprise in a system that centers sick care and incentivizes churning out services instead of improving outcomes.
In fact, only 60% of Medicare beneficiaries complete their annual well visits, and less than 65% of children under 19 complete their well-child check-ups. When done well, these encounters are vital opportunities to deepen relationships with patients, dedicate time to reviewing health risks that normally lose priority during problem-focused visits, and chart a healthier future.
The burden of process
The problem isn’t their purpose. It’s the process. For many reasons, preventive care has been systematically deprioritized. Though repetitive and routine, preventive visits consume substantial time and operational capacity without commensurate resources or reimbursement. Both practices and patients are expected to accomplish these when patients feel well and are less likely to seek care.
This requires outreach: time and effort that is easily usurped in busy clinics already overwhelmed by the daily demands of primary care. Additionally, scheduling preventive care may often compete with access for patients with more pressing health care needs. In order to support this vital part of our health care system, we must alleviate the burden to the practice and the patients, without sacrificing its inherent value in order to achieve sustainability.
Part of the path to this sustainability could rely on paving an entirely new way of working. Given the crisis-level primary care workforce shortage, perhaps there is a better way to meet patient needs for problem-oriented care and also support better individual and population health through more prevention. Done properly, the latter decreases the burden of the former.
The promise of agentic AI
The most impactful solutions will address the most common challenges of annual preventive visits. No matter the life stage, there are commonalities.
First, these visits rarely require the highest level of clinical skill, yet the work often rolls uphill to physicians. Second, their value stems from an extensive process of data collection and information synthesis to inform individually tailored prevention plans (work that is, by definition, repetitive, rules-based, and documentation-intensive). Third, the cognitive, time, and resource tax on physicians and practices is potentially a distraction from the management of patients who are actively suffering or require more complex medical decision-making.
These common denominators mean they are primed to be addressed through the thoughtful application of agentic artificial intelligence. An AI capable of performing complex, multistep tasks end-to-end without constant human intervention may be the solution.
A virtual concierge
This type of AI holds the power to act as a virtual concierge for every predictable step in the preventive care cycle:
- Invisible translation: Navigating the complex payer contract terms and industry standards, translating these into patient-specific action items.
- A seamless workflow: Completing a list of precise steps, which generally include identification of eligible patients, scheduling outreach, pre-visit patient intake, analyzing health risk assessments, synthesizing fragmented data, preparing an encounter agenda, recommending and coordinating evidence-based services, teeing up personalized prevention plans, creating patient/caregiver education materials according to identified health risks and industry standards, generating encounter documentation, and supporting post-visit patient follow-up.
- The financial guardrail: Taking over the chaotic, complex process of coding and billing. By natively managing documentation to meet payer standards and automating the coding process, AI ensures practices capture every eligible reimbursement, transforming preventive care from an administrative cost center into a high-impact, sustainable revenue center.
Preventive visits for all ages happen on a recurring and predictable life cycle: Lather, rinse, repeat. With agentic AI, every step in the process could be escorted through that cycle end-to-end by automation, making it foolproof from start to finish.
Agentic AI eliminates the distraction of thinking about steps in a process that forces physicians to act as data collection clerks, process navigators, and coding experts and ensures professional time is invested in the high-impact activities that only a human can do: clinical decision-making, patient empowerment through collaboration and counseling, and building trust.
By automating the logistical, repetitive tasks of predictable workflows like preventive visits, we don’t just solve a documentation problem; we unleash the value of human interactions at the heart of health care and support the sustainable future of primary care.
Sara Pastoor is a family physician.
