The situation
Author Health's care cadence — how often a patient should be seen — historically ran on a system called Phasing: three tiers that set MD/NP visit frequency based on psychiatric severity alone. There was no equivalent standard for psychotherapy or care management, so two of the platform's three core services had no defined engagement expectation at all.
Phase was also hard to get right in practice. Providers determined it manually against loosely defined inclusion criteria, and adherence had eroded badly: more than 55% of in-treatment Phase 1 and 2 patients weren't being scheduled to the cadence their phase implied. Providers often documented a different recommendation directly in the visit note instead of updating phase, which meant re-engagement staff had to read through notes to figure out what a patient actually needed rather than trusting the field on the chart. None of this gave leadership a defensible number to forecast revenue or clinic staffing against — the two things phase was originally built to support.
Replacing a single number with a care-team-owned model
I led the full redesign from the Q4 discovery charter through clinical criteria design and staged rollout, partnering with clinical and population health leadership to define what "the right cadence" means for each service:
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Split the concept by service
Core Service Intensity (CSI) replaced the single MD/NP-driven phase with three independent intensity ratings — and carried both an intensity (High, Moderate, Stable) and associated cadence (Weekly, Biweekly, Monthly, Quarterly). The model supports a separate CSI for Psychiatry, Psychotherapy, and Care Management — each owned by the clinician actually delivering that service.
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Wrote clinical criteria clinicians could apply
Each intensity tier is defined against named, checkable inputs — ED/inpatient utilization within a lookback window, PROM thresholds (PHQ-9, GAD-7, PANSS-6, PCL-5, ZBI-22), medication complexity (polypharmacy, controlled-substance count, recent changes), diagnostic acuity, and unmet SDOH needs — linked directly into the Maya visit workflow so a provider never has to leave the chart to check the guideline.
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Built in clinical override, with a paper trail
CSI defaults a specific cadence based on the intensity chosen (e.g., High + Biweekly). However, if a provider or patient lands on a cadence below what's clinically recommended, Maya requires a structured reason before it will save (patient financial constraints, patient preference, other) — preserving clinical judgment while giving us real data on why patients fall off the recommended cadence, instead of just knowing that they did.
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Forced re-evaluation on a fixed clock
CSI has to be reconfirmed every 90 days; Maya surfaces a badge on the care plan and a required field in the visit workflow when it's due, so a patient's intensity can't go stale the way phase did.
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Migrated the population and sunset phase everywhere
We migrated existing phased patients in psychiatry with a mandatory re-evaluation prompt at the patient's next visit. I scoped and sequenced removing every phase reference across the product so providers and ops staff had exactly one system of record for cadence, not two competing ones.
Extending intensity into scheduling
Cadence data is only useful if it changes what gets scheduled. I extended CSI into the Maya scheduling workflow: when staff book a patient's next Psychiatry or Psychotherapy visit, Maya now recommends a target date computed from the patient's last kept appointment and their intensity's cadence. For example, a biweekly patient defaults to a T+10-business-day recommendation, with a 3-day buffer before staff are required to enter a reason for booking further out.
I defined the reason taxonomy — author-driven reasons like provider or facilitator availability, versus patient-driven reasons like financial constraints or preference — so operations leadership can see which off-cadence patients are recoverable with a schedule change and which aren't. That same logic upgraded the platform's Core Service Scheduling Status tags from a binary "has a future appointment" flag into a status that distinguishes on-cadence, off-cadence-but-fixable, and off-cadence-but-expected — which now drives Author's re-engagement queues directly.
What changed
CSI launched in February 2026, replacing phase across the platform. Post-launch adherence and forecasting-accuracy metrics are still accumulating.
The scheduling-status upgrade already gives operations leadership a persistent, queryable view of cadence adherence that didn't exist under phase — the first time the business has had a single source of truth to measure against, rather than a manually-audited spreadsheet. In practice, that means re-engagement staff can work a queue sorted by who's actually recoverable with a schedule change, instead of triaging every off-cadence patient the same way — and leadership can distinguish a patient who's off-cadence because a slot wasn't available from one who's off-cadence by choice, rather than lumping both into a single adherence miss.
Figures reflect internal program data as of Q4 2025/Q1 2026, generalized for public sharing. Outcome metrics are pending post-launch measurement.