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Scienza Health
CLINICAL DECISION SUPPORT

Proactive Decision Orders

The residents who need attention today — and the reasons why.

5–10
residents flagged per facility, each day
3
specific reasons behind every recommendation
27B+
clinical records the rules are calibrated against
THE MORNING QUESTION

Who do I see first?

Every shift opens with the same quiet triage. A full census, a narrow window before rounds, and one question underneath all of it: of everyone in the building, who needs me today?

Most of the answer is already in the chart. A fall last week. A return from the hospital three days ago. A resident who is eighty-nine and has been close to the edge for a month. The signal exists. It is simply spread across pages no one has time to reassemble before eight in the morning.

Proactive Decision Orders reassembles it. Each morning it reviews your active residents, surfaces the handful who warrant attention first, names the action worth considering, and shows the patient-specific reasons behind each one.

It hands a clinician a shorter list — and leaves the judgment where it belongs.

IMPORTANT

Advisory decision support. A clinician reviews every recommendation, and no order is ever placed automatically.

THE PROBLEM

The problem PDO solves

Clinicians in skilled nursing and assisted living facilities manage large panels with high clinical complexity. Early warning signs — a fall last week, a recent return from the hospital, a resident on the edge for a month — are often missed not because clinicians lack skill, but because no system connects the signals and surfaces them at the right time.

71% of senior living operators ranked risk monitoring and predictive insights as the #1 area where technology can improve resident wellness.

— PointClickCare / Senior Housing News New Tech Adoption in Senior Living 2026 Survey

THE DAILY BRIEF

A brief, not a database

The page reads like a morning report, not a search tool. It opens with how many residents were prioritized and when the list was prepared, then a short read of the day’s patterns, then the residents themselves — ranked, most pressing first. Each resident card shows:

  • A risk tier — Critical, High, Moderate, or Low
  • The recommended order or action, set as the most prominent line on the card
  • Three reasons, drawn only from that resident’s own chart
  • A standing reminder: clinician review required, no automatic ordering
7residents flagged today
Synthetic demo
1HighFall PreventionJane S.MRN ••••3271 · Cedar Wing
Recommended order · for clinician review
Fall prevention protocol + PT consult
Why flagged
  • 2 falls in the last 90 days
  • Age 88 (85+)
  • Neurodegenerative screening signal
Clinician review requiredNo autonomous ordering
Illustrative — the Proactive Decision Orders worklist. Synthetic data; not a real resident.
TRANSPARENT BY DESIGN

No black box

Every recommendation is explainable: a clinician can read exactly why a resident is on the list. Proactive Decision Orders is built from clear clinical rules over data already in the chart — each resident is checked against a focused set of rules, the single strongest concern is kept, residents are ranked by tier and rule strength, and the most pressing few are returned. Every line on a card traces back to something a clinician can see in the record.

1
It explains itself. Every recommendation traces to the chart.
2
It never diagnoses. It surfaces concerns for review.
3
The clinician decides. Always.
FOCUS

What PDO surfaces today

PDO leads with the two concerns that matter most in post-acute and long-term care — with more concern areas on the roadmap.

Fall Prevention
Prior falls, advanced age, and cognitive screening signals
Hospitalization / Transfer Review
Recent return or transfer, and acuity
GOVERNANCE & SAFETY

Decision support, under clinician control

The safeguards are not added on top of the product. They are the product’s operating boundary.

  • Clinician review required on every recommendation
  • No orders placed automatically — at any point
  • Explainable rules , with no diagnosis generation
  • Human-in-the-loop by design
  • Resident data stays scoped to your organization, with full audit logging
  • Every recommendation traces to the resident's own chart
HIPAA-alignedAES-256Five-layer governanceHuman-in-the-loop
Clinical decision support software, with clinician review. That is not a tagline. It is the boundary.
THE FOUNDATION

Calibrated against the population it serves

PDO’s clinical rules are calibrated against one of the largest post-acute EHR datasets in the United States — built on the same resident population it serves. The screening signal PDO can draw on is grounded in peer-reviewed speech-biomarker science.

Unique residents
12.3M+
Clinical events
27B+
Diagnosis records
210M+
MDS assessments
62M+ (920 fields each)
ADL / CMI observations
1.3B+
Settings
SNF and ALF · 2020 to present
WHO IT IS FOR

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

Expected outcomes

Projections based on published literature on proactive clinical decision support in post-acute care settings. To be validated in pilot deployment.

OutcomeExpected Impact
Avoidable hospital transfersEarly detection enables proactive clinical management
30-day readmission ratePost-discharge risk signals surfaced for clinician review
Fall ratePrior-fall and cognitive screening signals surfaced for clinician review
TOGETHER

PDO and GIA®

PDO and GIA® are complementary clinical intelligence systems built on the same data foundation. GIA® screens residents through a short interaction and surfaces early cognitive and behavioral signals — grounded in peer-reviewed speech-biomarker science. PDO reviews the full EHR daily and shows the clinician who needs attention and what to consider. GIA® also administers structured instruments — BIMS (MDS 3.0 Section C), ADL and IADL assessments — written back to the EHR, where they become part of the record PDO reads.

See GIA® for Value-Based Care →

STATUS

Ready for the floor

  • The clinician-facing brief is built and ready for deployment
  • One pilot is complete; a second is under a signed letter of intent
  • Pilot program open for skilled nursing and assisted living facilities
It gives a clinician the shortest honest answer to the first question of the day. The rest stays human.
GET STARTED

See PDO in your facility

PDO is available for skilled nursing and assisted living facilities through a focused pilot program. Book a walkthrough to see how the daily brief reads in your building.

Featured in McKnight's Long-Term Care News →

Listed on PointClickCare Marketplace

Read about screening vs clinical decisions →