Surfacing Clinical Calculators in the EHR at the Point-of-Care

Co-authored by Shane Bell, EHR Practice Lead

Clinical calculators are no longer dusty relics buried in textbooks or external websites—they’ve become essential, integrated tools in modern healthcare. As we explored in our first blog post, clinical calculators transform complex data into actionable insights, supporting decisions on diagnosis, treatment, and risk assessment. These tools enable clinicians to transition from manually interpreting laboratory data and coordinating subsequent care steps to efficiently assessing patient risk scores that offer comprehensive insights. This facilitates a more integrated approach by illuminating the interconnections among diagnoses, comorbidities, and risk factors.

Today, these calculators are increasingly embedded directly within Electronic Health Records (EHRs), such as Epic®, allowing them to work seamlessly in the clinician’s workflow. Let’s take a closer look at how this plays out in real-life patient care.

Practical Applications in Healthcare

Case Studies: Calculators in Action

ASCVD Risk Calculator

One key example is the ASCVD Risk Calculator, which estimates a patient’s 10-year risk of heart attack or stroke. Clinicians can input factors such as:

• Age
• Sex
• Prior ASCVD diagnosis
• Systolic blood pressure (90-200 mm Hg)
• HDL cholesterol (20-100 mg/dL)
• Total cholesterol (130-320 mg/dL)
• Diabetes status
• Tobacco smoking status

This tool is crucial for identifying high-risk patients and guiding interventions, such as prescribing statins or lifestyle modifications. For example, in Epic®, it’s integrated across multiple areas of the patient chart, including the Storyboard and SmartLinks, allowing quick access and documentation, as seen in UNC Health’s implementation.

CHA2DS2-VASc Score

Similarly, the CHA2DS2-VASc score calculates stroke risk in patients with atrial fibrillation. Variables include:

• Age
• Sex
• Congestive Heart Failure
• Hypertension
• Diabetes Mellitus
• Stroke/TIA History
• Vascular Disease

According to UCSD, the scoring system, depicted below, which can also be used alongside the online CHA₂DS₂-VASc Calculator, helps determine whether patients need anticoagulation therapy to reduce stroke risk.

Images from UC San Diego Stroke Assessment Page depicting each of the risk factors and their associated point system.

Early Intervention: Impact on Patient Outcomes

These calculators facilitate early intervention by providing clinicians with risk assessments. For instance, the ASCVD calculator enables the identification of cardiovascular risk before symptoms develop, supporting preventive treatments. Likewise, the CHA2DS2-VASc score can inform discussions about blood thinner use to help reduce the likelihood of strokes.

Embedding these calculators in the EHR turns them from “nice-to-have” tools into proactive patient safety instruments. Clinicians aren’t forced to leave the chart to hunt for external tools; insights are presented at the point of care, when decisions matter most.

Integration into Electronic Health Records (EHR) Systems

Epic’s Approach

Epic® Systems, one of the largest EHR vendors, has invested heavily in integrating calculators into its workflows. Some standout integration points include:

• Multi-Provider Schedule – Providers can add custom columns, such as ASCVD risk scores, directly to daily patient lists, enabling proactive scheduling and prioritization, as outlined in Virtelligence’s insights on Epic’s scheduling capabilities.
• Storyboard – Displays key patient data at a glance on the left-hand side of the Epic main screen, including calculated scores, so clinicians can quickly assess risk without digging through charts, as described in the Storyboard Overview.
• SmartLinks – Epic SmartLinks are dot phrases that can be used anywhere there are discrete data fields, such as Epic My Note, that allow clinicians to drop calculated scores right into clinical notes with simple commands (e.g., by typing ".ASCVDRISK" This boosts documentation efficiency and ensures consistency, according to Medicine Matters.
• Sidebar Reports – A dedicated “Scores” section, that appears on the right-hand side of the Epic main screen, lets clinicians review calculated metrics without leaving the patient chart. Third-party tools like AvoMD can also plug into this sidebar for interactive guidance.
• Flowsheets – These templated tools display trends over time, enabling clinicians to track calculated scores and spot early signs of deterioration, all from one screen, as noted in the Connect Care Manual.

These integrations ensure clinical calculators are not isolated tools but embedded partners in care delivery.

Challenges and Considerations

Despite their promise, clinical calculators come with challenges:

• Data Accuracy: Calculations are only as good as the data entered into the EHR. Outdated labs or missing diagnoses can produce misleading risk scores, as discussed in this PMC article on CDS tools.
• Complex Clinical Scenarios: In patients with multiple comorbidities, no calculator replaces nuanced clinical judgment.
• Awareness: Many users are unaware of the calculators that are available in their systems, and if they are aware, may not have the habit of using them on the appropriate patients.

Healthcare organizations must prioritize both technical integration and clinician education to unlock the full value of these tools.

The Future of Clinical Calculators in the EHR

The future looks bright—and more sophisticated—for clinical calculators:

• Integration of Patient Lab Data: Calculators will increasingly rely on automatically updated lab results for real-time precision.
• Artificial Intelligence (AI) and Machine Learning: Emerging calculators will use AI to analyze complex patterns across massive datasets, predicting risks with even greater accuracy, as highlighted in Epic’s Predictive DSI initiatives.
• Personalized Medicine: Calculators aim to provide predictions based on individual genetic profiles, lifestyle factors, and social determinants of health.

Epic’s strategy of combining in-house tools with third-party innovations through its Epic Showroom ensures the ecosystem will continue expanding to support these advances.

Conclusion

Clinical calculators, like the ASCVD, CHA2DS2-VASc, and many others, are transforming how clinicians identify and manage patient risk. By making users aware of these tools in systems like Epic, healthcare providers gain immediate access to life-saving insights right at the point-of-care. While challenges remain, especially around accuracy and availability of input data, the direction is clear: clinical calculators are becoming indispensable allies in proactive, personalized care.

Let’s Connect

At Point-of-Care Partners (POCP), we’re passionate about helping life sciences manufacturers unlock the full potential of clinical calculators in healthcare. Whether your goal is to empower providers with practical tools, build educational resources that drive adoption, or explore opportunities to innovate new calculators in areas with unmet needs, our team can guide you through both the strategic and regulatory considerations.

Has your organization leveraged ASCVD or CHA2DS2-VASc or other calculators in Epic, or other EHR platforms? We’d love to hear about your experiences, successes, or challenges. If you’re curious about how clinical calculators could play a role in your organization’s strategy—or how to get them into the hands of providers where they can truly make a difference—let’s start a conversation.