A mechanism is provided in a data processing system to implement a healthcare cognitive system which operates for predicting engagement items for care providers. An engagement item prediction component executing within the healthcare cognitive system detects a scheduled appointment between a patient and a doctor. The engagement item prediction component scans communication pattern and details of patient communications for indicators of a medical condition of the patient. The healthcare cognitive system generates a set of one or more questions related to the medical condition. The engagement item prediction component presents the set of one or more questions to the user and receives one or more responses to the set of one or more questions from the patient. The healthcare cognitive system generates one or more seed topics based on the one or more responses and presents the one or more seed topics to the doctor for the scheduled appointment.