Protocol slippage,
caught before it compounds.
Clinical Stewardship Monitoring checks every recorded visit against your stewardship protocols, including antibiotic, steroid, controlled-substance, and additional customer-configured protocols, so deviations surface immediately, not in the next audit.
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.
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.
Antibiotic Stewardship
Checks antibiotic prescribing decisions against appropriate-use criteria for the presenting condition.
Steroid Stewardship
Monitors steroid prescribing for appropriateness and documentation of clinical rationale.
Controlled-Substance Monitoring
Flags controlled-substance prescribing patterns against your clinical protocols and risk thresholds.
Customer-Configured Protocols
Additional stewardship domains configured per customer requirement; the set is extensible to the protocols your organization monitors.
Azithromycin 500mg prescribed
Viral URI, no bacterial indicators
GUIDELINE: CDC 2024 — antibiotics not indicated for viral URI
Prednisone 40mg prescribed
Mild allergic rhinitis, no documented failed first-line therapy
GUIDELINE: Step therapy — first-line antihistamines not documented
Tramadol 50mg refill
Refill at 28 days — prior 30-day supply, no documented gap
GUIDELINE: CS monitoring — early refill flag threshold: <30 days
Your Protocol
Additional stewardship protocols configured per customer requirement.
Every deviation is sourced to the specific transcript line. Not inferred — cited.
The outcome ladder
- Systematic stewardship review at every visit, catching protocol slippage before it accumulates into a quality problem.
- Network-level stewardship trends: identify prescribing pattern shifts early.
- Audit-ready stewardship documentation: every visit, every flagged deviation, every source citation.
- Defensible evidence for payer inquiries and accreditation reviews.
- Reduction in inappropriate prescribing costs, with deviations caught early, before patterns spread across the network.
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.
First Stop Health
Transitioned from manual, statistically insignificant sampling to a governance model that analyzes every provider interaction across a national network.
“We aren't projecting these numbers. This is in production today, powering our clinical governance at scale.”
Deployed within the First Stop Health governance model: 100% of 250,000+ annual visits reviewed, 99% expert-aligned accuracy across all clinical protocol checks.
Built for this task, not bolted onto an EMR or wrapped around a generic LLM. Every output is traceable.
See it run on your data.
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.