Precision Analgesia's clinical validation engine integrates with Epic, Cerner, and Meditech via SMART on FHIR and CDS Hooks — transforming standalone decision support into enterprise-grade, EHR-embedded forcing functions.
Opioid complications are no longer just clinical errors — they are existential legal and financial threats that demand systemic, hardwired solutions.
Annual System Burden
Opioid Use Disorder accounts for 7.86% of all hospital expenditures. A single OIRD episode creates a $3,500 cost variance per case.
Undetected Risk
The PRODIGY Trial revealed 46% of floor patients experience respiratory depression. Manual nursing checks miss the vast majority of these events.
Alert Fatigue
Soft warning popups are bypassed 90% of the time by clinicians. BPA-integrated forcing functions — not passive alerts — are required to change behavior.
Recent verdicts (e.g., Asante Rogue — $303 Million) establish that hospitals are directly liable for systemic "Failure to Monitor" defects. Passive warnings no longer provide safe harbor. The legal standard now demands hardwired safeguards embedded at the point of prescribing.
Six validated clinical modules — purpose-built to reduce opioid-related adverse events, close prescribing gaps, and generate auditable compliance documentation.
24-drug database with route-aware, organ-adjusted dosing and cross-tolerance reduction. Validated against CDC 2022 and NCCN 2025 guidelines.
Mandatory safety checks for renal failure, hepatic decompensation, pregnancy, pediatrics, QTc prolongation, and geriatrics. BPA-integrated forcing functions — not bypassable alerts.
Non-linear NCCN/APS tiered conversion ratios with QTc monitoring, elderly overrides, and stepwise 3-day transition schedules. Replaces dangerous static conversion tables.
5-phase structured clinical pathway: Screening (DAST-10, ASSIST) → DSM-5 Diagnosis → COWS Assessment → MOUD Induction → Discharge. Generates complete SOAP notes.
14-factor PRODIGY/RIOSORD composite scoring with auto-generated monitoring plans per risk tier. Detects synergistic risks (benzodiazepines + COPD/OSA "Triple Threat").
167 automated test scenarios across 10 suites. Every recommendation hyperlinked to source guideline — full "Glass Box" transparency for independent clinician review.
Three steps from clinician action to evidence-based recommendation — no additional training, no workflow disruption.
Physician clicks a button in Epic or Cerner. The EMR opens a secure SMART on FHIR session — either embedded in the chart or in a new window.
OAuth 2.0 token exchange authenticates the session. The app queries patient demographics, lab values (eGFR, LFTs, QTc), and current medications via FHIR R4.
App loads instantly with patient context pre-filled. Safety gates auto-execute, OIRD risk is scored, and the clinician receives gated, evidence-based recommendations.
When a clinician selects or signs an opioid order, Epic fires a CDS Hook to our service endpoint. The Precision Analgesia engine evaluates all 10 safety rules in real-time and returns actionable cards — warnings, dose adjustments, and alternative recommendations.
For critical safety gates (renal contraindications, pediatric black box warnings), hospital Epic teams configure Best Practice Advisories (BPAs) powered by our logic — creating true forcing functions that require clinical justification to override.
Age, sex, demographics
Renal, hepatic, pregnancy, COPD, OSA, CHF (ICD-10)
Creatinine/eGFR, LFTs, QTc interval (LOINC)
Active opioids, benzodiazepines, naltrexone (RxNorm)
A unified clinical intelligence platform — not a collection of standalone calculators.
| Capability | Precision Analgesia | General Tools |
|---|---|---|
| Safety Gates | 10-rule mandatory engine, auto-applied | Manual — clinician must remember |
| Workflow | End-to-end single interface | Fragmented separate apps |
| Risk Scoring | Automatic PRODIGY + monitoring plans | Standalone calculators |
| OUD Pathway | Full 5-phase wizard + SOAP notes | Not available |
| Traceability | "Glass Box" — every rec sourced | Black box outputs |
| Validation | 167 automated clinical scenarios | None published |
| HIPAA | Zero data persistence — ephemeral by design | Varies |
From sandbox validation to live clinical deployment — a structured, low-risk rollout designed for enterprise health systems.
Register on Epic's developer portal. Build SMART on FHIR launch flow, implement FHIR R4 queries, validate CDS Hooks service endpoint against synthetic patient data.
Security risk assessment and HIPAA BAA execution with partner hospital. Epic staging environment configuration, clinical workflow review with pharmacy and nurse informaticists. Private SMART app registration — no Connection Hub listing required for pilot.
Limited deployment on select medical-surgical floors. Real-world clinical validation with identified physician champions. Data collection and outcome tracking against baseline metrics.
Pilot expansion, Epic Connection Hub listing application, and broader system-wide availability. Continuous outcome tracking for ROI documentation and settlement fund reporting.
Built for Non-Device CDS compliance from the ground up. No 510(k) clearance required — meeting all four FDA criteria by statute means zero device regulatory overhead for your IT department.
No image, waveform, or device-signal processing. All inputs are discretized clinical parameters from structured EHR fields.
Designed exclusively for physicians, NPs, PAs, and clinical pharmacists. Mandatory clinical responsibility acknowledgment on every session.
Full formula, data inputs, and intermediate calculations displayed for every recommendation. Zero black-box outputs — complete derivation shown.
All safety gates are advisory recommendations with documented overrides (resolved by design, June 2026). A confirmatory counsel memo is planned before EHR BPA integration.
Classified under Section 3060(o)(1)(E) of the 21st Century Cures Act. Our deterministic, fully-traceable engine is designed to meet all four criteria — every safety gate is an advisory with a documented override, with a confirmatory counsel memo planned before BPA integration. No 510(k) FDA clearance required.
Saves 12–24 months vs. SaMD clearance path · Zero post-market surveillance burden
Every recommendation is hyperlinked to its source guideline (CDC 2022, NCCN 2025, AGS Beers Criteria 2023, ASAM 2020). Clinicians can independently verify any recommendation against primary literature in under 30 seconds. The clinician always retains full prescribing autonomy.
One-click to source · All formulas shown inline · Deterministic — not AI/ML
Architectural guarantee: all patient data is ephemeral — processed in-memory only with 30-minute auto-wipe. Zero data persistence to disk. No PHI leaves the EHR environment. The application operates entirely within your institution's security perimeter.
No BAA data warehouse · Zero PHI at rest · No breach surface for your CISO
Generates auditable logs of every forcing function activation and clinical override. Builds a defensible record demonstrating systemic safety infrastructure — directly addressing "failure to monitor" and "corporate negligence" legal theories from verdicts like Asante Rogue ($303M).
Every override documented · Every gate logged · Complete audit trail
The founder is an addiction medicine fellow beginning July 2026 — directly aligned with the platform's core clinical domain: OUD consultation, MOUD induction, COWS scoring, and buprenorphine protocols. This training pathway provides the clinical depth to advance from shadow-mode evaluation to IRB-exempt quality improvement pilot, generating real-world safety metrics that support hospital contract discussions.
Stage 2 — Active
Clinical Review
Stage 3 — Planned
Regulatory Counsel
Stage 4 — Planned
IRB-Exempt QI Pilot
Precision Analgesia qualifies as Qualified Abatement Technology. Hospital CFOs can fund 100% of licensing and integration costs via Opioid Abatement Settlement dollars — zero net cost to the institution.
Inquire About FundingWhether you're a CMIO evaluating clinical tools, a CFO exploring settlement-funded technology, or a physician champion seeking safer prescribing workflows — we're ready to discuss integration at your institution.
Direct Contact
dan@lifelinemedtech.org