ClaritasQI applies a large language model to uploaded chart PDFs, evaluating each applicable quality measure against defined CMS and TJC criteria. Output is a structured compliance scorecard — not a narrative summary — with a verdict, rationale, and supporting chart citation for each measure element.
ClaritasQI follows a structured, measure-driven evaluation sequence. For each applicable quality measure, the model is given the measure definition, inclusion and exclusion criteria, and the relevant chart content. It returns a verdict — PASS, FAIL, PARTIAL, or N/A — with a one-sentence rationale and the specific chart text that supports its finding. The process mirrors the logic of manual abstraction but applies it consistently across every uploaded record.
Hospital chart PDFs are uploaded through a secure, HIPAA-compliant interface. The system extracts and parses structured and unstructured text — physician orders, nursing notes, laboratory results, vital signs, and discharge documentation.
The model applies each relevant measure definition — drawn from CMS Core Measure specifications and TJC ORYX standards — against the extracted chart content. Each measure element is evaluated independently against its defined threshold and inclusion criteria.
Results are returned as a scorecard: a verdict for each measure element, a brief rationale citing the relevant chart finding, and an overall bundle or module compliance rate. Output is formatted for QI committee review and peer-review program documentation.
Manual chart abstraction is the current standard for most hospital QI programs. The following describes how ClaritasQI differs in practice — not as a replacement for clinical judgment, but as a structural alternative to the abstraction step itself.
Each module maps to a defined regulatory standard. Phase 1 modules are available at launch; Phase 2 and 3 modules are in development and will be added in subsequent releases.
| Module | Regulatory standard | Key elements evaluated | Phase |
|---|---|---|---|
| SEP-1 Sepsis Bundle | CMS Core Measure SEP-1 | 3-hr bundle, 6-hr bundle, lactate, blood cultures, antibiotics, fluids, vasopressors, repeat lactate | Phase 1 |
| ACS / STEMI | CMS OP-2/OP-3, ACC/AHA | Aspirin on arrival and discharge, statin, door-to-balloon time, reperfusion strategy documentation | Phase 1 |
| Stroke | CMS STK-1 through STK-10 | tPA eligibility and administration, DVT prophylaxis, antithrombotic therapy, rehabilitation assessment, smoking cessation counseling | Phase 1 |
| VTE Prevention | CMS VTE-1 through VTE-6 | Prophylaxis ordered and administered, ICU VTE prophylaxis compliance, discharge instructions | Phase 1 |
| Pneumonia / CAP | CMS PN-6, IDSA/ATS guidelines | Blood cultures before antibiotic administration, appropriate antibiotic selection, time-to-first-dose | Phase 2 |
| Heart Failure | CMS HF-1 through HF-3 | LVEF assessment, discharge instructions completeness, ACEI/ARB at discharge | Phase 2 |
| Perinatal Safety | TJC PC measures, ACOG | Elective delivery before 39 weeks, cesarean rate documentation, hemorrhage protocol adherence | Phase 2 |
| Surgical Care (SCIP) | CMS SCIP / TJC | Prophylactic antibiotic timing, selection, and discontinuation; VTE prophylaxis; normothermia; glucose control | Phase 2 |
| Pressure Injury | NDNQI, AHRQ NQF #0201 | Hospital-acquired Stage 3/4 PI, prevention protocol adherence, repositioning documentation | Phase 2 |
| Medication Reconciliation | TJC NPSG.03.06.01 | Reconciliation on admission, transfer, and discharge; high-alert medication documentation | Phase 3 |
| Fall Prevention | TJC NPSG.09.02.01 | Risk assessment performed, intervention implemented, post-fall review documentation | Phase 3 |
| Restraint Use | CMS CoP 42 CFR §482.13 | Order compliance, monitoring frequency, 1-hour face-to-face, least restrictive alternative documentation | Phase 3 |
Hospital QI departments operate under peer review protections — Texas Health & Safety Code §161 and equivalent statutes in other states. The framing of QI documentation matters for how those protections apply.
ClaritasQI output uses compliance-oriented language throughout: measures are met or not met, variances are noted as improvement opportunities, and findings are framed as QI committee action items. The platform does not use language associated with litigation support tools — no deviations, no critical gaps, no breach findings.
This distinction is intentional. The output language is written to support classification of ClaritasQI records as peer review program documentation, consistent with the framing hospital counsel and QI committees expect.
| Situation | Litigation-framed language | ClaritasQI framing |
|---|---|---|
| Missing documentation | Critical gap identified | Improvement opportunity noted |
| Protocol difference | Deviation from standard | Protocol variance documented |
| Criterion not met | Breach of standard | Measure not met |
| Reviewer action | Flagged for litigation review | QI committee action item |
| Output document type | Expert report | QI program scorecard |
| Regulatory reference | Chapter 74 / malpractice | CMS / TJC / QAPI |
ClaritasQI is a credentialed, access-gated platform. Sign in with your issued credentials, or contact us to discuss access for your department or QI program.
Sign In