CAUSE-ATTRIBUTED AUDIT FOR INTRAOPERATIVE HYPOTENSION

A retrospective audit that classifies the cause behind each intraoperative hypotension event in your group’s case data.

Anesthesia clinicians reason about hypotension causally at the bedside — vasodilation, hypovolemia, myocardial depression, bradycardia — and intervene accordingly. The case-level reasoning is sound. The dataset-level pattern across hundreds of events is invisible. M&M handles individual cases; PSI-90 reports the composite score; neither tells you what was driving your group’s IOH events last quarter. LINCR runs that audit on case data your AIMS already produces.

01 · WHAT THE AUDIT PRODUCES

Per-event attribution. Per-clinician burden. Defensible QI documentation.

Site-level pattern reports

Per-quarter cause distribution across every IOH event in your group’s case data, segmented by case type, length, anesthetic technique, and patient profile. Example finding: “63% of last quarter’s IOH events were vasodilation-mediated, clustered in cases longer than three hours with high MAC and propofol infusion.”

Clinician-level outlier identification

Case-mix-normalized IOH burden per anesthesiologist, with cause distribution and example cases attached for medical-director review. Example finding: “Dr. Smith’s vasodilation-mediated IOH burden is 2.4× group median, clustering in laparoscopic cases on high propofol infusion. 12 representative cases attached.”

Defensible QI documentation

Audit reports your QI committee, hospital quality department, and malpractice carrier can point to as evidence of structured QI activity. Documents that the group identified, attributed, and acted on a pattern.

02 · HOW IT DEPLOYS

Your existing case data. No EHR integration. No new instrumentation.

1
BAA + DATA EXPORT
Group signs a BAA. You export the case data your AIMS already produces — Epic Anesthesia, Cerner, AtlasIQ, or any other AIMS that supports a structured export. Typical setup: roughly one week.
2
90-DAY RETROSPECTIVE AUDIT
We run cause-attributed analysis across every IOH event in the case set covering the prior quarter. Per-case attribution, site-level pattern report, clinician outlier report, QI documentation export.
3
ANNUAL CONTRACT IF FIT
If the audit changes a protocol or surfaces a finding your QI committee acts on, an annual contract continues the audit at that facility and extends to others in your network as you choose. The 90-day pilot findings are yours regardless.
03 · SEE IT ON REAL DATA

One real intraoperative case from UC Irvine’s public MOVER dataset.

Live demo running the audit against the MOVER dataset (UC Irvine, 55,483 anesthesia cases, JAMIA Open 2023). One representative case with five IOH events spanning four different cause attributions, plus the aggregate distribution across 300 randomly sampled cases.

Live demo: causal-endotype audit on MOVER
Real intraoperative physiology, real IOH events, attribution rationale per event.
View Demo →
04 · WHAT SITS UNDERNEATH

CF2: a compartmentalized neural-ODE physiological estimator validated on the four largest open intraop datasets.

The audit is powered by CF2, a 63,975-parameter neural-ODE model that estimates per-subject physiological state from observable signals (blood pressure waveform or NIBP cuff, ECG, pulse oximetry, capnography, drug record). Validated against MOVER, VitalDB, MIMIC-IV, and eICU with publication-grade calibration on hypotension prediction. US provisional patent filed 2026-03-20 (USPTO #64/011,899, sole inventor: Anish Joseph).

Today’s product is the retrospective audit and the prospective risk-stratifier that follows in months three through six. Both ship under the FD&C Act §520(o)(1)(E) clinical-decision-support carve-out (21st Century Cures), so deployment does not require 510(k) clearance. Real-time bedside CDS is the year-two-to-three roadmap and will go through 510(k); not claimed as available now.

05 · FOUNDER

Built by a practicing Certified Anesthesiologist Assistant.

Anish Joseph
FOUNDER · LINCR, INC.

I administer the vasopressors, fluids, and inotropes the audit reasons about — on the patients in the populations the model is trained on. The model is mine (sole inventor on the provisional patent). The product is built around what an anesthesiologist actually classifies at the bedside, not around what an analytics layer can detect post hoc. Clinical questions welcome on the call.

15-minute call to evaluate fit.

If your group has IOH events that the current quality reporting doesn’t fully explain, this is worth one phone call. The 90-day audit is at no cost during the pilot phase and the audit findings are yours regardless of whether we proceed to a contract.

Email anish@lincr.io