Premera Engagement Operating Rhythm
Created: 2026-02-16 Status: DRAFT
Weekly Executive Update Template
Send every Friday EOD to: Colt, Jamie, John (cc: Chad once relationship established)
Template
Subject: DaisyAI × Premera — Week [N] Update ([date range])
## Wins This Week
- [Concrete deliverable or milestone, with metrics if possible]
- [Second win]
- [Third win if applicable]
## In Progress
- [What's actively being worked on + expected completion]
- [Second item]
## Blockers
- [Blocker] — **Owner:** [who can unblock] — **Impact:** [what's delayed]
- [Second blocker if any]
## Next Week Plan
- [Top 3 priorities for next week]
- [Any meetings/demos scheduled]
## Metrics Snapshot
| Metric | This Week | Last Week | Trend |
|--------|-----------|-----------|-------|
| Appeal cases processed (AI) | X | Y | ↑/↓ |
| Auto-auth conditions live | X | Y | ↑/↓ |
| Nurse satisfaction score | X/10 | Y/10 | ↑/↓ |
| Hours billed | X | Y | — |
## Asks
- [Anything we need from Premera this week]
Update Principles
- Lead with results, not activity. "Processed 47 appeals with 89% accuracy" > "Worked on appeals pipeline"
- Blockers are not complaints. Frame as: "We need X from Y to unblock Z by [date]"
- Metrics every week, no exceptions. Even if preliminary. Establishes credibility.
- Keep it under 1 page. Execs skim. If they want detail, they'll ask.
Risk Register
Reviewed weekly in internal standup. Escalated to Premera when status changes.
| # | Risk | Likelihood | Impact | Mitigation | Owner | Status |
|---|---|---|---|---|---|---|
| R1 | Provisioning delays — SRP tickets take 4 weeks through 5 teams | High | High | Pre-submit requests before contract signs. Colt to champion. Have fallback work (design docs, synthetic data). | Thomas + Colt | 🟡 Active |
| R2 | Data quality / access gaps — ADT feeds cover 80-90% but CCDs are sparse, claims data structure unknown | Medium | High | Start with what's available. Use Colt's team existing data pipelines. Document gaps early. | Thomas | 🟡 Active |
| R3 | Model hallucinations in clinical context — LLM generates plausible but wrong clinical reasoning | Medium | Critical | Mandatory human review for all denial-adjacent outputs. Confidence scoring. Nurse feedback loop. Never automate denials. | Thomas | 🟡 Active |
| R4 | Policy mismatch — AI interprets medical policies differently than InterQual criteria | Medium | High | Validate against nurse decisions on historical cases. Build criteria-specific test suites. Engage Romilla's clinical team for edge cases. | Both | 🔴 Not started |
| R5 | Capacity crunch — Both founders at 40h/week leaves no bandwidth for DaisyAI product, fundraising, other pipeline | High | Medium | Plan for it. Block time for VC calls. Identify tasks that can pause. Consider Dan Wilson's team for subcontracting. | Both | 🟡 Active |
| R6 | Scope creep — 12 UM initiatives, pressure to take on everything | Medium | Medium | Contract scoped to auto-auth + appeals. New asks go through formal change request. Weekly scope check in standup. | Michael | 🔴 Not started |
| R7 | Chad Murphy disengagement — CCO never sees the work, doesn't champion expansion | Medium | High | Schedule intro before or during Week 1. Deliver demo at Week 4. Build relationship through Romilla. | Both | 🔴 Not started |
| R8 | Enterprise security review drags — Company contract requires full security review process | Medium | High | Send security deck ASAP. Explore individual contractor route as faster alternative. Nathan can advise on timeline. | Thomas | 🟡 Active |
| R9 | Appeals March 1 launch fails — their existing system has issues, our work gets deprioritized | Low | Medium | Stay close to the launch. Offer to help debug. Use any turbulence as evidence they need more hands. | Both | ⚪ Monitoring |
| R10 | IP/legal ambiguity — foreground/background IP not settled, creates tension later | Medium | High | Address in contract before starting. Budget $10-35K for lawyer review (per hot-board). Don't build proprietary DaisyAI IP inside Premera's environment. | Thomas | 🔴 Not started |
Risk Status Key
- 🔴 Not started — mitigation not yet underway
- 🟡 Active — being monitored, mitigation in progress
- 🟢 Mitigated — controls in place
- ⚪ Monitoring — low likelihood, watching
Escalation Path & Response Times
Internal (DaisyAI → DaisyAI)
| Severity | Example | Response | Escalation |
|---|---|---|---|
| P1 — Production down | AI pipeline crashing, Elementum integration broken | 1 hour | Both founders immediately |
| P2 — Blocked | Can't access data, provisioning stuck, key person unavailable | 4 hours | Other founder + Colt |
| P3 — Degraded | Accuracy below threshold, slow processing, minor bugs | 24 hours | Discussed in daily standup |
| P4 — Enhancement | New feature request, optimization opportunity | Next weekly update | Backlog for planning |
External (DaisyAI → Premera)
| Issue | First Contact | Escalation | Timeline |
|---|---|---|---|
| Access/provisioning blocked | Colt or Jamie | John Hauser → Nathan | Same day |
| Data quality/availability issue | Nathan's team | Colt | 24 hours |
| Clinical accuracy concern | Romilla's clinicians | Chad Murphy (CCO) | 48 hours |
| Contract/commercial issue | Mark (vendor mgmt) | Colt → Talhah (CFO) | 1 week |
| Scope change request | Colt | John + Chad | Next weekly sync |
External (Premera → DaisyAI)
| Issue | First Contact | Response SLA |
|---|---|---|
| Production issue (P1) | Thomas (phone) | 1 hour |
| Technical question | Thomas (Slack/Teams) | 4 hours |
| Status request | Michael (email) | 24 hours |
| Strategic/scope discussion | Both (scheduled call) | Within week |
Meeting Cadence
| Meeting | Frequency | Attendees | Purpose |
|---|---|---|---|
| Daily standup | Daily, 15 min | Thomas, Michael, Colt (or delegate) | Blockers, priorities, quick decisions |
| Technical review | 2x/week, 30 min | Thomas, Nathan, Colt's engineering team | Architecture, code review, integration |
| Weekly executive update | Weekly, email | Colt, Jamie, John (cc Chad) | Written update (template above) |
| Biweekly demo | Every 2 weeks, 30 min | Colt, Jamie, Chad (invited), nurses | Show working software, get feedback |
| Monthly business review | Monthly, 45 min | Chad, Colt, John, Thomas, Michael | ROI, metrics, scope, roadmap |
| Internal DaisyAI sync | Daily, 10 min | Thomas, Michael | Capacity, fundraising, product balance |
❓ Questions Thomas Needs to Answer
- Q14: Communication tool — Does Premera use Slack or Teams? Do we get added to their workspace?
- Q15: Who approves scope changes? — If Colt asks us to pick up a third work stream, who signs off?
- Q16: How do we handle IP created during the engagement? — Need clarity before starting. Lawyer engaged?
- Q17: What's the billing/invoicing process? — Through Mark? Monthly invoices? Net 30?
- Q18: Do we need E&O / professional liability insurance? — Enterprise clients sometimes require this for consulting engagements.