### Target Population Designed for patients who meet specific criteria related to their engagement and assessment status. The target population includes patients who: - Have not had an annual assessment within the current year. - Have received fewer than 5 phone call attempts. - Do not have an upcoming appointment scheduled. - Do not have a "non interested" status. - Do not have tasks labeled as "Engagement" or "Transition." ### Recommendations Contacting patients who fall into the target population to ensure they complete their annual assessment. Confirmation the patient has been called recently and provides guidance on whether they should be contacted again or if no further action is required. ### Importance Identify patients who are overdue for their annual assessment and follow-up actions are taken. By targeting patients who have not been sufficiently engaged, it aids in improving compliance with annual assessments, which are crucial for monitoring and maintaining patient health. Additionally, it helps to streamline the follow-up process for clinical staff, ensuring that no patient is missed due to administrative oversights. ### Conclusion Supports clinician workflow by automating the process of identifying patients who need follow-up for annual assessments. By managing patient engagement more efficiently prioritizing calls based on patient status and recent interactions. Reducing manual tracking efforts leading to better patient management and improved outcomes.