CLEO — Costa Rica's AI Assistant for Purging Surgical Waiting Lists

Costa Rica's Caja Costarricense de Seguro Social (CCSS), the country's single public health insurer, has deployed CLEO, a virtual-assistant tool that cross-references the EDUS unified digital health record, the national Civil Registry, and provider networks to identify patients on surgical, procedure, and consultation waiting lists who may no longer need the service.

CLEO aims to reduce backlogs on CCSS's waiting lists by identifying patients who no longer need a scheduled procedure and confirming this with a defined, auditable set of resolution categories rather than removing anyone unilaterally.

CLEO contacts flagged patients directly by WhatsApp, phone call, and email, applying one of 15 official resolution categories — such as 'no longer needs surgery', 'deceased', or 'already treated elsewhere' — to each case. Every AI-flagged removal requires human validation by CCSS staff before it is executed, so the system recommends but does not unilaterally decide. Deployed from 2023 and scaled through the first quarter of 2026, the system can process up to 1,500 records per day.

CLEO has resolved 367,403 patients off surgical waiting lists, including 136,774 cases specifically purged as no longer needing surgery. Over that period, CCSS's national list-depuration rate fell from 31.2% in 2023 to 18.2% in Q1 2026. CCSS allocated ₡7,122 million (roughly US$14 million) for a further targeted push between May and October 2026, aiming at 100,125 additional resolutions.

The figures are self-reported by CCSS but corroborated consistently across four independent Costa Rican outlets over more than a year of coverage, which strengthens confidence in the topline numbers even though no independent technical audit of CLEO's accuracy or categorisation logic has been published.