Coordination Flow — Pediatric Obesity Care

A walk-through of one week of care, showing how the same moment looks on three different screens. Designed to show real doctors, parents, and teens for feedback.

Scenario

Aizhan, age 13. BMI at 96th percentile. No comorbidities yet. Lives with mom (Gulnara) and grandmother. Started care plan 2 weeks ago with Dr. Akmatov, pediatric endocrinologist. This is the second week of the plan.

Doctor

Parent

Teen

Sunday Evening

Plan for the week is set

AI drafts a weekly micro-plan based on last week's data and the long-term plan from the visit. Doctor reviews and approves in under 30 seconds. The same plan is then translated into a coaching version for the parent and an autonomy-respecting version for the teen.

Dr. Akmatov

Pediatric Endocrinologist

9:42 PM●●●

Pending review

Aizhan T. — Week 2 plan

F, 13y · BMI 96%ile · Last visit Mar 24

AI suggests for next week:

● Sleep ≥ 8 hours, 5 nights
● Walk after dinner, 4 evenings
● Family meal at table, 3 times

Last week sleep avg6h 50m

Mood trendStable

ED screenNegative

✓ Approve & send

Gulnara

Mom

9:43 PM●●●

New from Dr. Akmatov

This week with Aizhan

3 small things, agreed with Dr. Akmatov

Sleep — help her be in bed by 10 pm. Phone out of the room helps.

Walk after dinner — 15 min, 4 evenings. Go with her if you can.

Family meal at table — 3 times. No phones. No weight talk.

Important

No weight conversations this week. Praise effort, not body. If grandma comments on Aizhan's eating, redirect gently.

Aizhan

Age 13

9:43 PM●●●

Hey Aizhan. Hope your weekend was good.

We picked 3 small things for this week with you and Dr. Akmatov. Nothing wild — just stuff that's been working for you.

→ Try to be in bed by 10
→ Walk after dinner with mom (if you want)
→ Eat dinner at the table with family

That's it. No tracking food. No checking weight. You get to tell me how it goes.

What to notice: the doctor sees clinical signals and has 1-tap approval. The parent sees coaching language with a safety reminder. The teen sees the same 3 things framed as her choice — no weight, no calories, no tracking. Same plan, three completely different presentations.

Monday Evening

Daily check-in (30 seconds)

The teen has one short conversation a day. No food log. No weight. One question that matters today.

Dr. Akmatov

Pediatric Endocrinologist

8:15 PM●●●

No alerts

Today

No urgent items.

Aizhan T. — week 2, on track. Next visit Apr 22.

This week

14 patients with active plans. 0 red flags. 2 yellow signals (review when convenient).

Gulnara

Mom

8:15 PM●●●

Tonight

It's a walk-after-dinner night

If you can, go with Aizhan tonight. Even 10 minutes. Don't make it about weight — just about being together.

This week so far

Plan started today. Nothing to report yet.

Aizhan

Age 13

8:14 PM●●●

Hey. Quick one — how was today, on a scale of 😞 😐 🙂 ?

🙂

Nice. School ok?

it was fine. tired tho

Got it. Sleep tonight will help. Want me to remind you at 9:45?

ya ok

Done. That's it for tonight ✌️

What to notice: the teen interaction took 30 seconds and asked nothing about food or body. The parent gets a coaching nudge timed to her evening. The doctor's screen is quiet — no alerts means no work. Quiet is the goal.

Tuesday Evening — Hard Moment

Private channel + protected coaching

Aizhan has a fight with her mom about food. She tells the AI privately. The parent does NOT see what Aizhan said — but receives a non-identifying coaching nudge that helps her handle the moment.

Dr. Akmatov

Pediatric Endocrinologist

7:22 PM●●●

Logged — no action

Aizhan T. — context note

Family food conflict reported by patient. ED screen still negative. Mood within normal range. No clinician action needed. Logged for next visit context.

Why you're seeing this

Soft signal only. The AI is handling it. You'll see this in the pre-visit summary.

Gulnara

Mom

7:21 PM●●●

A small heads-up

Tonight may be tense

Try a low-pressure shared moment

It can help to step out of the food conversation for a bit. Could you watch one episode of something together, or take a short walk later?

If she pushes back tonight, that's ok. You don't have to win.

Things to avoid right now

✗ "You need to eat this"
✗ "Think about your health"
✗ Any comment about her body

Aizhan

Age 13

7:18 PM●●●

my mom is being so annoying again

Ugh, sorry. What happened?

she keeps telling me what to eat. like im a kid

That's frustrating. You're 13, not 6. She's worried but it's coming out as control.

i just wanted to skip dinner

Got it. Skipping a meal once isn't a big deal. Quick check though — are you skipping because you're not hungry, or because you don't want to deal with her?

the second one

Ok that makes sense. Want me to give your mom a tip about backing off tonight, without telling her what you said?

ya pls

This is the most important step in the demo. Three things to notice. (1) The teen has a private channel — the parent never sees the actual conversation. (2) The parent gets useful coaching that helps her handle tonight, without breaking trust. (3) The AI also screened the answer ("are you skipping because you're not hungry?") for early eating disorder signals. Negative this time. If it had been positive, the doctor would be alerted instead of the parent.

Wednesday Evening

Parent asks for help

Gulnara opens her app in the middle of a hard moment and asks for a script. This is the highest-leverage parent feature — turning food conflict into a teachable moment in real time.

Dr. Akmatov

Pediatric Endocrinologist

6:48 PM●●●

Today

No alerts.

14 patients on plans. 1 in pre-visit window (Aizhan T., Apr 22).

Gulnara

Mom

6:47 PM●●●

Hi Gulnara. What's going on?

She won't sit at the table. Grandma made plov. I told her she has to eat with us.

That's a hard moment. You did the right thing inviting her. Now I'd suggest backing off the "has to" part.

Try this:

"If you don't want to sit with us tonight that's ok. The food will be in the kitchen if you want it later. We'd love your company though."

Then walk away. Don't follow up. Don't mention her weight, her health, or "your father and I."

but she'll just not eat

Maybe tonight. That's fine. One missed dinner doesn't matter. The relationship is what matters this week.

Aizhan

Age 13

6:48 PM●●●

(Aizhan isn't on her phone right now. The system never tells her "your mom is asking about you.")

What to notice: the parent gets an actual sentence she can use in the next 60 seconds. Not a graph. Not a list of foods. A script. The teen's phone stays silent — there is no notification that her mom asked about her, ever.

Friday Evening

Week in review — three different views

Same week, same data, three completely different views. This is the coordination layer in action.

Dr. Akmatov

Pediatric Endocrinologist

5:30 PM●●●

Aizhan T. — Week 2

On track

Sleep avg7h 30m ↑

Walks completed3 of 4

Family meals2 of 3

Mood trendStable

ED screenNegative

Family conflict1 episode (handled)

Family food conflict on Tue. Coached in real time. No clinician action needed. Will discuss at next visit only if relevant.

Gulnara

Mom

5:30 PM●●●

One thing to celebrate

Aizhan slept better this week

She averaged about 40 minutes more sleep per night than last week. That's a real change. Tell her you noticed she seemed more rested — not "you slept more."

One thing to try next week

Tuesday was hard. Going forward, when there's tension at the table, the goal is the relationship, not the meal. You handled Wednesday well.

Aizhan

Age 13

5:30 PM●●●

Hey, want a quick recap of this week?

You slept way better this week. Like, noticeably. That's a big deal — your body needs that.

You walked after dinner 3 times. The Wednesday one was when it was raining and you still went 👏

Tuesday sucked. We figured it out. That counts too.

No homework. Have a good weekend ✌️

What to notice: the same week is described three completely different ways. The doctor sees clinical signals. The parent sees one win plus one thing to try. The teen hears about effort and small wins, never about her body, never with numbers. Nothing about Tuesday's private conversation leaks to the parent.

3 Days Before Next Visit

Pre-visit briefing for the doctor

When the next clinic visit approaches, the AI generates a one-screen pre-visit summary the doctor can read in 60 seconds. This is the doctor-side of the value proposition — and the thing that makes the whole system economically viable.

Dr. Akmatov

Pediatric Endocrinologist

4:10 PM●●●

Visit in 3 days

Aizhan T. — 60-sec briefing

F, 13y · BMI 96%ile · Visit Apr 22, 10:30

Trajectory

Plan adherence75%

Sleep↑ 40 min/night

Mood / ED screenStable / Negative

Suggested agenda

1. Acknowledge sleep win directly to patient
2. Family food tension — light touch, don't dwell
3. Mom asking whether GLP-1 is "off the table"
4. Next 4-week plan

Confidentiality flag

✗ Do not mention Tuesday's private conversation in front of mom.

Gulnara

Mom

4:10 PM●●●

Visit in 3 days

Apr 22, 10:30 with Dr. Akmatov

Anything you want to bring up? Tap to add to the agenda — Dr. Akmatov will see it before you arrive.

Already on the agenda

• Your question about GLP-1 medications
• Aizhan's sleep improvements
• Next 4 weeks of the plan

Aizhan

Age 13

4:10 PM●●●

Heads up — you have a visit with Dr. Akmatov in 3 days.

Anything you want to ask him without your mom in the room? I can pass it along, or you can tell him directly when you get there.

No pressure. Just an option.

What to notice: the doctor's briefing has a "do not bring up in front of mom" line — protecting the teen's confidentiality is built into the clinical workflow. The teen also gets an explicit private channel to her doctor. The parent sees the agenda items SHE put on the list — never the teen's private items.

For your feedback session

Ask doctors: would the pre-visit briefing actually save you time? What would you cut? What's missing? Would you trust the ED screen?

Ask parents: does this feel like help or surveillance? Where does it overstep? Where does it not go far enough? Does it feel weird that you can't see what your kid says to the AI?

Ask teens: would you actually use this? What would make you delete it on day one? Does the private channel feel real, or do you assume your mom can secretly see it?