Multi-Agent System for Pediatric Vaccine Reminder and Schedule Management

Manual tracking of complex, age-based schedules across hundreds of patients is error-prone and labor-intensive. This workflow automates schedule calculation against CDC/ACIP guidelines, integrating with the EHR to track each dose. By proactively identifying due/overdue patients, it reduces missed vaccinations—directly improving public health metrics and preventing revenue loss from unfilled well-child visits.

Staff spend hours calling, texting, and emailing parents for reminders. This system deploys specialized communication agents that send personalized, multimodal reminders (SMS, email, IVR) in the family's preferred language. It handles confirmations, rescheduling, and FAQs, cutting front-desk call volume by 40-60% and increasing appointment show rates, which stabilizes schedule density and revenue.

Manual entry into the state Immunization Information System (IIS) is slow and risks audit findings. An integration agent automatically formats and submits vaccination data via HL7 or REST APIs post-administration, ensuring real-time registry compliance. This creates a defensible audit trail, eliminates duplicate data entry, and positions the practice for favorable quality-based reimbursement tied to reporting completeness.

Vaccine reminders are a direct lever for well-child visit attendance, a core revenue driver. By bundling reminder logic with intelligent waitlist management, the system auto-fills cancellations to protect utilization. Furthermore, it identifies patients due for other preventive services (e.g., lead screening, developmental assessments) during outreach, creating upsell opportunities within the scheduled visit and increasing revenue per patient.

A custom build using frameworks like LangGraph allows precise orchestration of specialized agents (scheduler, communicator, IIS integrator, auditor) with built-in approval gates and observability. This architecture ensures safe exception routing (e.g., contraindication flags, parent opt-outs) to clinical staff, provides full audit trails for compliance, and scales from a single clinic to a multi-location practice without losing reliability.

Implementation starts with a 4-6 week pilot on a single vaccine series (e.g., DTaP) for a controlled patient cohort. The build phase focuses on core integrations with the practice's PMS/EHR (e.g., Epic, Athena) and the state IIS, using sandbox environments. Post-pilot, the workflow is expanded to all recommended vaccines, with monitoring dashboards tracking completion rates, parent engagement metrics, and staff time savings to prove ROI before enterprise rollout.

This core agent maintains a real-time, patient-specific vaccine calendar by ingesting birthdates and historical doses from the EHR and performing a daily, bidirectional sync with the state IIS registry via HL7 VXU/VXQ messages. It normalizes conflicting records, flags catch-up opportunities, and updates the master schedule, eliminating manual registry lookup and data entry that consumes 15-20 minutes per patient annually.

Governs all patient and parent communications. It evaluates the schedule to trigger age-appropriate, multimodal reminders (SMS, email, IVR) 2-4 weeks before a due date. It uses preference and engagement history to optimize channel and timing, and initiates follow-up sequences for missed doses. The orchestrator integrates with the practice's PM system to block schedule slots for well-visits directly from reminder interactions.

When a reminder is acknowledged, this agent engages the parent via conversational AI to book the accompanying well-visit. It checks real-time provider schedules, respects booking rules (e.g., physician preferences, block times), and optimizes for clinic throughput. It can manage waitlists and auto-fill cancellations, directly converting reminders into revenue-generating appointments and maximizing provider utilization.

Post-administration, this agent listens for EHR vaccine-administration events, verifies the dose against the scheduled plan, and automatically updates the IIS via a VXU message. It then reviews the clinical note for completeness, suggests appropriate CPT (90460, 90461) and ICD-10 codes for preventive care, and validates them against payer policies to prevent denials, ensuring accurate reimbursement for vaccine administration.

Manages all workflow exceptions and escalations. It catches parental concerns (e.g., fever, allergy questions) from conversational flows, adverse event reports, and schedule conflicts (e.g., illness). It triages these based on clinical logic, routing non-urgent items to nursing staff via task queue and flagging urgent clinical questions for immediate provider review in the EHR inbox, preserving safety and clinician oversight.

Continuously analyzes population-level data to measure immunization rates, identify cohorts falling behind (e.g., patients overdue for HPV series), and trigger targeted recall campaigns. It generates reports for quality measures (e.g., HEDIS) and simulates the impact of outreach strategies. This engine turns operational data into actionable growth initiatives, systematically closing care gaps.