Rule-based CDS engines
Configurable rules engines. Drug-drug interactions, allergy checking, dose-range validation, guideline adherence.
Service · Clinical decision support
Point-of-care decision support, out of the way until it matters.
Rule-based and ML-driven CDS, integrated into clinician workflow. Evidence-graded, audit-ready, and designed to stay out of the way until the moment a recommendation could change an outcome.
CDS · order signed
42 msChecking 5 rules…
- Allergy checkchecking
- Drug-drug interactionqueued
- Dose-range validationqueued
- PDMP checkqueued
- Renal dosingqueued
What we build
Six things, in one engagement.
ML-driven recommendations
Models trained on your population, evidence-graded recommendations with explainability per suggestion.
CDS Hooks integration
Native EHR-embedded recommendations via the CDS Hooks standard. Works in Epic, Cerner, Athenahealth.
Order sets + care pathways
Standardized, evidence-based order sets per condition. Condition-specific care pathway automation.
Alert governance + audit
Per-clinician alert metrics, override tracking, alert-fatigue dashboards, evidence-of-effect reports.
Clinical validation harness
Prospective trial infrastructure to validate CDS impact before scaling. Designed for IRB-reviewable deployment.
Tech we work with
CDS HooksFHIR R4DroolsPythonPyTorchEpic App OrchardCerner CodePostgreSQL
Compliance scope
- HIPAA Security Rule
- FDA Clinical Decision Support guidance
- Evidence-grading frameworks (GRADE)
Our process
Predictable delivery — even when the scope isn't.
015 days
Audit & plan
We review your code, infrastructure, and compliance posture. You get a written report, architecture diagram, gap analysis, and a fixed-price roadmap.
022-week sprints
Rescue or build
Weekly demo. Live dashboard with sprint velocity, open issues, and burndown. Read access to our repo from day one.
03Continuous
QA & compliance
Automated and manual testing, security review, HIPAA-readiness check, optional third-party penetration test.
04Ongoing
Deploy & optimize
Production launch with monitoring, on-call rotation if you want it, continuing development at a steady cadence.
FAQ
Questions we get on the first call.
Will the FDA regulate our CDS as a medical device?
It depends on what the CDS does. We help you scope intended use against the FDA's CDS guidance — there's a meaningful line between non-device CDS (information for the clinician to evaluate) and SaMD (autonomous recommendation). We build for either path.
How do you avoid alert fatigue?
We instrument override behavior and tune sensitivity per clinician. Most engagements get to <10% override rate within the first 90 days — vs industry averages of 40-90%.
Can you measure clinical impact?
Yes. We build the prospective trial infrastructure as part of the engagement — control vs intervention arms, automated outcome tracking, IRB-ready reports.
Insights · Read more
Background reading for buyers.
EngineeringNov 8, 2023
CDS Hooks: shipping clinical decision support clinicians actually use
CDS Hooks is the standard for delivering decision support inside the EHR — but standards don't drive adoption. Here's what separates CDS that gets accepted from CDS that gets disabled in week two.
Serhii Kholin · 9 min
AIDec 15, 2025
Building a clinical validation harness for ML in healthcare
Models that work on benchmarks don't always work in your hospital. Here's the validation infrastructure we wish every team had on day one.
Serhii Kholin · 11 min
MedTechMar 26, 2020
IEC 62304 in practice: what it actually requires (and what people get wrong)
62304 doesn't tell you to write tests. It tells you to write tests that trace to requirements that trace to user needs. Here's what that looks like in a real codebase.
Serhii Kholin · 14 min
Start with the audit
5 days. Written report. No commitment.
Tell us what you're building or what's not working. We'll come back with a written audit and a fixed-price plan.