Proactive Decision Orders
PDO analyzes every active patient’s EHR data daily and surfaces a concise, ranked list of clinical recommendations — before deterioration occurs, not after. Physicians see exactly which patients need attention today and precisely what to order, with the three clinical reasons behind each recommendation drawn from the patient’s own data.
The Problem PDO Solves
Physicians in skilled nursing and assisted living facilities manage large patient panels with high clinical complexity. Early warning signs — a quiet drop in blood pressure, a tenth concurrent medication, a week of declining function scores — are often missed not because clinicians lack skill, but because no system connects the signals and surfaces them at the right time.
What PDO Delivers
- A daily ranked list of patients who need clinical attention — 5 to 10 per facility, no more
- Three specific clinical reasons per patient, drawn from their own EHR data
- A specific recommended order for each flagged condition
- Delivered before rounds, directly into the physician’s workflow
PDO is not a prediction. It is a recommendation. Not “this patient might deteriorate” — but “here is what to order, here is why, and here is the patient’s own data to support it.”
How PDO Works
- Every night, PDO pulls structured clinical data from PointClickCare across all active patient stays
- A machine learning model evaluates each patient and assigns risk scores for hospital transfer, falls, and functional decline
- For each high-risk patient, PDO identifies the three clinical factors driving their risk
- Each factor maps to a specific, appropriate physician order
- Each morning before rounds, the physician receives a concise brief — ranked patients, recommended orders, supporting reasons
- The physician reviews, applies clinical judgment, and acts
The Data Behind PDO
PDO is trained on one of the largest post-acute EHR datasets in the United States — built exclusively on the same patient population it serves.
- Unique patients
- 12.3M+
- Clinical events
- 27B+
- Diagnosis records
- 210M+
- Medication administration events
- 16.2B+
- MDS assessments
- 62M+ (920 fields each)
- ADL/CMI observations
- 1.3B+
- Data range
- 2020 to present
- Settings
- SNF and ALF
What PDO Is Not
- PDO does not replace clinical judgment — physicians review and approve every recommendation
- PDO does not make autonomous clinical decisions
- PDO does not diagnose conditions
- PDO does not generate orders without physician review and approval
Who PDO Is Built For
- Physicians and nurse practitioners in skilled nursing facilities
- Medical directors managing large patient panels
- Assisted living facility clinical teams
- Post-acute care operators focused on reducing avoidable transfers and improving quality metrics
Expected Outcomes
Projections based on published literature on proactive clinical decision support in post-acute care settings. To be validated in pilot deployment.
| Outcome | Expected Impact |
|---|---|
| Avoidable hospital transfers | 10–20% reduction |
| 30-day readmission rate | 8–15% reduction |
| Fall rate | 15–25% reduction |
| Medication safety events | 20–30% reduction |
PDO and GIA® Together
PDO and GIA® are complementary clinical intelligence systems built on the same data foundation. GIA® screens patients through a short interaction and flags early cognitive and behavioral risk. PDO analyzes the full EHR daily and tells physicians what to do next. Together they form a proactive clinical intelligence layer for post-acute and long-term care.
GIA® also administers structured clinical assessment instruments — including BIMS (MDS 3.0 Section C), ADL assessments (Barthel Index, Katz Index), and IADL assessments (Lawton Scale, FIM) — with results written back to the EHR. This structured assessment data becomes part of the clinical record that PDO analyzes nightly.
Note: PDO analyzes ADL and CMI observations from historical EHR data as model inputs. GIA® administers ADL and IADL assessment instruments to capture new structured patient data — these are distinct capabilities that work together.
Get Started
PDO is available for skilled nursing and assisted living facilities through a focused pilot program. Book a walkthrough to see how PDO works in your facility.