Telehealth Intelligence/Clinical Stewardship Monitoring
Solution

Protocol slippage,
caught before it compounds.

Clinical Stewardship Monitoring checks every recorded visit against your stewardship protocols — antibiotic, steroid, controlled-substance, and additional customer-configured protocols — so deviations surface immediately, not in the next audit.

100%
Recorded Visit Coverage [FSH-3]
250K+
Annual Visits Reviewed [FSH-2]
99%
Expert-Aligned Accuracy [FSH-5]
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Stewardship protocols are only as good as your coverage.

Antibiotic overprescribing, steroid misuse, and inappropriate controlled-substance prescribing are known risks in telehealth. The problem isn't the protocol — it's that stewardship can only be enforced where QA reviews happen. At 2–5% sampling, the vast majority of visits go unmonitored.

Mechanism

What it does

Clinical Stewardship Monitoring applies your stewardship protocols to every recorded visit — checking prescribing decisions against the applicable guideline and flagging deviations with a source-linked citation to the transcript. Findings roll up to provider-level and network-level stewardship views.

01

Antibiotic Stewardship

Checks antibiotic prescribing decisions against appropriate-use criteria for the presenting condition.

02

Steroid Stewardship

Monitors steroid prescribing for appropriateness and documentation of clinical rationale.

03

Controlled-Substance Monitoring

Flags controlled-substance prescribing patterns against your clinical protocols and risk thresholds.

04

Customer-Configured Protocols

Additional stewardship domains configured per customer requirement — the set is extensible to the protocols your organization monitors.

Live demo — 847 visits this week · 3 protocols active · extensible
Antibiotic Stewardship
0VISITS REVIEWED
23 FLAGS RAISED
DEVIATIONPT-5571

Azithromycin 500mg prescribed

Viral URI, no bacterial indicators

GUIDELINE: CDC 2024 — antibiotics not indicated for viral URI

Steroid Stewardship
0VISITS REVIEWED
11 FLAGS RAISED
DEVIATIONPT-1092

Prednisone 40mg prescribed

Mild allergic rhinitis, no documented failed first-line therapy

GUIDELINE: Step therapy — first-line antihistamines not documented

Controlled-Substance Monitoring
0VISITS REVIEWED
6 FLAGS RAISED
REVIEW REQUIREDPT-8832

Tramadol 50mg refill

Refill at 28 days — prior 30-day supply, no documented gap

GUIDELINE: CS monitoring — early refill flag threshold: <30 days

Custom Protocol
0VISITS REVIEWED

Your Protocol

Additional stewardship protocols configured per customer requirement.

Every deviation is sourced to the specific transcript line. Not inferred — cited.

Business Impact

The outcome ladder

Clinical
  • Systematic stewardship review at every visit — catch protocol slippage before it accumulates into a quality problem.
  • Network-level stewardship trends: identify prescribing pattern shifts early.
Risk & Compliance
  • Audit-ready stewardship documentation — every visit, every flagged deviation, every source citation.
  • Defensible evidence for payer inquiries and accreditation reviews.
Cost & Efficiency
  • Reduction in inappropriate prescribing costs — deviations caught early, before patterns spread across the network.
Paired Solutions

Paired with Visit-Level Quality Assurance

Clinical Stewardship Monitoring applies protocol-specific analysis within the broader quality structure that Visit-Level Quality Assurance provides. For VPs of Clinical Quality who need both full audit coverage and stewardship depth, the capabilities run together.

CASE STUDY • FIRST STOP HEALTH

First Stop Health

Transitioned from manual, statistically insignificant sampling to a governance model that analyzes every provider interaction — across a national network.

NETWORK SIZE1,000+ Providers [FSH-1]
ANNUAL ENCOUNTERS250K+ Visits [FSH-2]
AUDIT COVERAGE<5% → 100% [FSH-3]
ANNUALIZED SAVINGS$2.0M [FSH-4]
CLINICAL ALIGNMENT99% [FSH-5]

“We aren't projecting these numbers. This is in production today, powering our clinical governance at scale.”

REFERENCE DATA [FSH-1:5] • Q1 2026 AUDIT
[FSH-1] 1,000+ providers in the First Stop Health clinical network.
[FSH-2] 250,000+ recorded visits analyzed annually.
[FSH-3] Audit coverage expanded from <5% manual sampling to 100% automated review.
[FSH-4] Annualized reduction in QA operational costs and risk mitigation.
[FSH-5] Performance alignment measured against blind double-read by clinical directors.

Deployed within the First Stop Health governance model — 100% of 250,000+ annual visits reviewed, 99% expert-aligned accuracy across all clinical protocol checks.

Deterministic Scoring
Scored against your own clinical guidelines, visit by visit.
99% Expert Alignment
Validated against expert clinical reviewers across 250,000+ visits.
Source-Linked Audit Trail
Every score traces to a specific line in the transcript — defensible in any audit.

Not an EMR query. Not a generic LLM. Every output is traceable.

Served personas
Next Steps

Not a demo.
A working session.

Bring your stewardship protocols and a sample of prescribing data. We'll show you how 100% coverage changes what deviations you can catch — in 45 minutes.

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CogniSwitch / Clinical Stewardship Monitoring
© 2026