Sepsis bundle prompting
Surfaces Surviving Sepsis bundle steps when vitals and labs cross thresholds.
Clinical Intelligence Agent
Clinical decision support software development
Alerts that clinicians dismiss by reflex protect no one. Agnotic Technologies builds clinical decision support software that reads the open chart and shows a few cited recommendations the clinician can accept or override.
Clinician-in-the-loopCDS HooksHIPAA-ReadyAudit Logged
Trusted by global innovators
What is clinical decision support software development?
Clinical decision support software development is building software that checks a patient's chart against clinical guidelines or predictive models and shows recommendations inside the EHR at the moment of a decision. Agnotic Technologies builds it for health systems and digital health companies with CDS Hooks, SMART on FHIR, visible reasoning and clinician override.
Guidelines for sepsis bundles, VTE prophylaxis, statin eligibility and antibiotic stewardship change faster than any clinician can track. Rigid rule-based alerts only add alert fatigue.
The software checks the live FHIR record (problems, medications, labs, vitals, allergies) against encoded guideline logic and returns a few evidence-linked recommendations through CDS Hooks. The clinician accepts, modifies or dismisses each one, and nothing is ordered automatically.
CDS Hooks in the EHR
Our CDS Hooks development connects the service to your EHR at patient-view and order-sign, reads FHIR R4 context, and keeps the guideline library and audit trail as their own layers.
What do we build for AI CDS?
Decision support grounded in guidelines or validated models, delivered inside the clinician's workflow.
Guideline-based recommendations
A clinical rules engine encodes society guidelines (USPSTF, ACC/AHA, IDSA, Surviving Sepsis) into machine-checkable logic matched against the live chart, so only what applies is shown.
Delivered via CDS Hooks
Fires on patient-view, order-select, and order-sign hooks so recommendations appear as cards in the native EHR workflow.
Alert-fatigue tuning
Suppression logic, per-guideline thresholds, snooze windows, and firing analytics keep signal high and override rates low.
SMART app suggestions
Cards launch a SMART on FHIR app or write a pre-populated order the clinician confirms, from a versioned, change-logged guideline library.
Where it runs
Where does decision support help most?
Antibiotic stewardship
Flags de-escalation and guideline-concordant choices to prescriber and stewardship pharmacist.
Preventive care gaps
Prompts USPSTF-grade screenings: statin eligibility, cancer screening, immunizations.
VTE prophylaxis
Checks risk-stratified prophylaxis on admission and order-sign for hospitalists.
What changes for clinicians?
Directional: actual results depend on guideline scope, firing thresholds, and baseline override rates.
Fewer
Reflex-dismiss alerts through suppression tuning
In-workflow
Recommendations delivered via native CDS Hooks cards
Cited
Every recommendation carries an evidence citation
Compliance-First Healthcare App Development Services Backed by Global Standards
01
HIPAA
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, strict access controls, and traceable audit logs.
02
GDPR
General Data Protection Regulation
Implement lawful consent flows, data minimization, retention controls, and secure processing for sensitive health data.
03
FHIR
Fast Healthcare Interoperability Resources
Enable standardized health data exchange across apps, care teams, and systems through standards-based FHIR APIs.
04
HL7
Health Level Seven International
Support enterprise-grade interoperability with HL7-based integrations for records, events, and clinical messaging workflows.
05
HITRUST
Health Information Trust Alliance
Align security programs to healthcare-specific control and risk management practices trusted by providers and ecosystem partners.
06
HITECH
Health Information Technology for Economic and Clinical Health Act
Design with breach notification readiness, digital record safeguards, and operational controls that support regulated care programs.
07
SaMD
FDA Software as a Medical Device
Plan software quality, traceability, and documentation pathways for products that may require SaMD review and submission.
08
MDR (EU)
Medical Device Regulation (European Union)
Prepare EU market-ready processes for risk classification, evidence tracking, and lifecycle governance under MDR expectations.
09
SAMHSA
Substance Abuse and Mental Health Services Administration
Apply confidentiality controls and consent-aware sharing models for behavioral and mental health data experiences.
Standards we build against
Which standards does CDS connect to?
CDS HooksFHIRSMARTHIPAAONC
How It Works
How does a recommendation reach the clinician?
Read FHIR context, reason against guideline logic, surface a recommendation, and log the decision.
1.
Capture: CDS Hooks context
A patient-view or order-sign hook passes FHIR context: problems, medications, labs, vitals, and allergies.
FHIR R4 context
2.
Processing: guideline reasoning + guardrails
The agent matches the record against guideline logic, grounds each rationale in the cited source, and suppresses redundant cards.
Evidence-grounded
3.
Action: clinician-in-the-loop card
A CDS Hooks card presents the recommendation with citation and rationale; the clinician accepts, modifies, or dismisses it.
Human-in-the-loop
4.
Write-back: decision + audit trail
Accepted suggestions flow into orders or the note; the decision, rationale, and guideline version are logged to an immutable audit trail.
Audit logged
Facts and sources
Non-device CDS criteria and other rules
Short facts we design clinical decision support around, each linked to its primary source.
CDS Hooks is an HL7 specification that lets an EHR call an external decision support service at points in the clinician's workflow, such as opening a chart or signing an order.
Source: HL7 International (CDS Hooks)FDA's Clinical Decision Support Software guidance explains which decision support functions meet the non-device criteria in section 520(o)(1)(E) of the FD&C Act and which remain device software functions.
Source: FDA guidance, Clinical Decision Support SoftwareThe ONC (ASTP) certification criterion for decision support interventions requires certified health IT to let users review source attributes of predictive interventions, including their intended use, intended patient population and known risks or limitations.
Source: 45 CFR 170.315(b)(11) (eCFR)The NIST AI Risk Management Framework is a voluntary framework that organizes AI risk work into four functions: Govern, Map, Measure and Manage.
Source: NIST AI 100-1
Related proof
Read Case StudyLera Health: compliant women's health platform
Related proof of compliant, AI-assisted delivery, not this exact agent. For Lera Health we built the privacy-first data layer and testing-to-insights workflow that turns clinical data into personalized guidance.
Compliance & Guardrails
What compliance and security does CDS need?
Decision support touches patient safety directly, so access, consent, explanations and logging are engineering decisions made from the first sprint.
PHI handling
Chart data stays inside your compliance boundary under a BAA, encrypted throughout, with no PHI used to train shared models.
Clinician-in-the-loop
The agent recommends; the clinician decides. No order or note is finalized without explicit human action.
Explainability
Every recommendation shows its guideline citation and the triggering patient data, so clinicians verify rather than trust a black box.
Audit logging
Fires, accepts, modifications, dismissals, and guideline versions are logged immutably for override analytics.
Frequently Asked Questions
The software runs inside your compliance boundary under a signed business associate agreement, with PHI encrypted in transit and at rest and never used to train shared models. Every card that fires, and every accept, change or dismissal, is audit-logged.
No. It is assistive by design. It surfaces evidence-linked CDS Hooks cards, and no order or note is finalized without a human decision.
A chatbot answers whatever you type, with no patient access or audit trail. This software reads the live FHIR chart, checks it against versioned, cited guidelines, and delivers recommendations in the EHR.
It depends on what the software does. Section 520(o)(1)(E) of the FD&C Act excludes some decision support from the device definition, but not software that analyzes medical images or signals, and the clinician must be able to review the basis for each recommendation independently. We document the intended use and keep the reasoning visible so your regulatory team can assess it early.
Use the EHR's built-in rules when a simple alert on coded data is enough. Build custom CDS when the logic spans several systems, needs a predictive model, must run in more than one EHR, or needs explanations and override analytics the EHR cannot show.
It depends on how many guidelines or models the first release covers, which EHR and CDS Hooks points you use, how much of the needed data is coded rather than free text, and how long the silent shadow-mode run must be. We give you a timeline after the scoping call.