The Governance Layer for Clinical Decision Support.
Ship CDS changes safely. Audit-ready. Confidently.
The Cost of Status Quo
Alert fatigue is the status quo
Override rates above 90%. Nurses tune out. The alerts meant to protect patients become noise—but no one can prove which ones to cut safely.
Evidence is too slow to build
Manual chart review, ad-hoc SQL, months of committee cycles. By the time you have answers, the protocol has already drifted.
Performance now hits revenue
As of FY2026, SEP-1 (sepsis) score impacts Medicare reimbursement.
Fear of dropping SEP-1 keeps noisy alerts firing.
~1,200 hospitals score zero SEP-1 points. Many others are scoring low.
Sepsis protocols alone can involve 50+ interacting rules across nursing, physician, and pharmacy workflows. Governance committees aren't slow because they don't know what to change. They're slow because they can't prove the change is safe.
The FY2026 Regulatory Deadline
CMS has moved SEP-1 into the VBP Safety Domain. For the first time, sepsis measure performance directly affects Medicare reimbursement. The compliance clock is running.
Hospitals face up to a 2% Medicare payment adjustment based on VBP Total Performance Score. SEP-1 non-compliance now carries a direct revenue penalty.
Alert override rates above 90% are the norm. Without tooling to prove that logic changes are safe, governance committees cannot act fast enough to meet compliance timelines.
How It Works
Connecting clinical intent to EHR execution—with evidence.
Purpose-built for Epic BPA environments. No FHIR integration required.
Instead of debating in committee for months, teams see the impact of proposed changes before anything ships. Evidence for every decision. Audit trail for every change.
See What’s Hidden in Your CDS Rules Forest
Surface collisions. Prove safety. Export implementation-ready artifacts.
Alert Override Analysis
INSIGHTSAcross 4 high-volume units
Collision Families
6 clusters detectedSEP-1 Risk Audit
COUNTERFACTUAL ANALYSISCohort Safety & Compliance Validation
SIMULATIONAgainst proposed policy change
About
Rephana.ai is building governance infrastructure for clinical decision support systems. Health systems run hundreds of CDS rules across sepsis, VTE, opioids, falls, and more - with no systematic way to assess the risk of changing any of them. The result: committees that freeze, alert noise that compounds, compliance exposure that grows silently, and clinicians who absorb the cost. EHRs provide build environments. Reporting platforms show what already failed. Neither solves the core problem: proving that a proposed change is safe, auditable, and defensible before it reaches production. Rephana.ai provides the infrastructure layer that makes CDS changes defensible. Currently in stealth and engaging selectively with health system leaders and strategic partners.
Connect on LinkedIn →Request early access
We're speaking selectively with CMIOs, CNIOs, VP Quality leaders, Clinical Informatics Directors, and Nursing Informatics Directors at Epic-based health systems—plus strategic partners and long-term investors.