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  • Clinical AI
  • Clinical Decision Support
  • Product Leadership

Clinical evidence, built into software clinicians trust.

MRH Solutions helps health systems and digital health companies design, validate, and ship clinical AI and decision support. The work is led by a pharmacist with a decade of hands-on CDS, interoperability, and product experience.

Start a conversation See selected work

Matt Hiott, PharmD, MBAFounder, MRH Solutions

  • 100+ clinical decision support guidelines built
  • ~10 years in clinical decision support
  • Epic & Cerner EHR environments delivered into
  • PharmD, MBA clinical depth with business training

01Services

Clinical depth from strategy to shipped product.

Engagements are scoped to what you need: a focused advisory sprint, hands-on design and build support, or ongoing product leadership.

  1. Clinical AI strategy & validation

    Decide where AI belongs in clinical workflow, then show it is safe and useful before it reaches patients.

    • Use-case assessment and clinical risk review
    • Evaluation plans with clinician-in-the-loop review
    • Guardrails, explainability, and governance input

  2. Clinical decision support design

    Evidence-based logic that fires at the right moment for the right patient, without adding to alert fatigue.

    • Guideline-to-logic translation and rule authoring
    • Alert and workflow design for Epic and Cerner (Oracle Health)
    • Content lifecycle: review, versioning, and maintenance

  3. Interoperability & clinical terminology

    Standards-based integration that carries across sites and EHRs instead of being rebuilt for each one.

    • CDS Hooks service and card design
    • FHIR resource mapping and data requirements
    • RxNorm and SNOMED CT code binding and value sets

  4. Product leadership

    Fractional or interim product management from someone fluent in both clinical and engineering conversations.

    • Roadmaps, requirements, and prioritization
    • Discovery with clinical stakeholders
    • Launch readiness for clinical products

Working fluency in

  • Epic
  • Cerner (Oracle Health)
  • HL7 FHIR
  • CDS Hooks
  • RxNorm
  • SNOMED CT

02Approach

A clear path from clinical question to working software.

The same discipline behind more than 100 delivered guidelines, applied to your problem: start with the clinical decision, then design, validate, and sustain.

  1. Frame the clinical decision

    Start from the decision, not the technology: who decides, when, with what information, and what could go wrong.

    Typical outputsUse-case brief, clinical risk review

  2. Design the logic and data

    Translate evidence into computable logic or AI requirements, bound to the right FHIR resources and terminology.

    Typical outputsLogic specifications, data and terminology map

  3. Validate with clinicians

    Test against realistic patient scenarios, review with practicing clinicians, and agree on clear release criteria.

    Typical outputsTest scenarios, release criteria

  4. Launch and sustain

    Plan the rollout, watch signals like overrides and clinician feedback, and keep content current as evidence changes.

    Typical outputsLaunch plan, monitoring and maintenance cadence

03Selected experience

Representative work in CDS and clinical AI.

A few examples of the problems I’ve worked on. Organization names and identifying details are left out to respect client and employer confidentiality.

01Clinical content · Health IT

  • Epic
  • Cerner
  • RxNorm
  • SNOMED CT
  • Content governance

Scaling a guideline library across Epic and Cerner

Challenge
Evidence-based recommendations had to reach clinicians inside different EHRs, each with its own build conventions, data model, and constraints, without fragmenting into site-specific one-offs.
Approach
Built a structured path from clinical evidence to computable logic: explicit inclusion and exclusion criteria, terminology bound to RxNorm and SNOMED CT, and testing against realistic patient scenarios before release into Epic and Cerner environments.

Outcome

More than 100 clinical decision support guidelines built and maintained over roughly a decade, with a repeatable process from evidence review to deployment.

02Digital health · EHR integration

  • CDS Hooks
  • FHIR R4
  • RxNorm
  • Workflow design

Point-of-care recommendations with CDS Hooks and FHIR

Challenge
Guidance needed to show up inside the ordering workflow, at the moment of decision and using data the EHR already holds, rather than in a separate tool clinicians had to remember to open.
Approach
Defined the hook triggers (such as order-select and order-sign), the FHIR resources and prefetch each rule depends on, medication normalization to RxNorm, and card designs with clear rationale and actionable suggestions, weighed against alert burden.

Outcome

A standards-based integration pattern that delivers recommendations in workflow and can be reused across sites instead of rebuilt for each one.

03Clinical AI · Product leadership

  • Clinical AI
  • Evaluation
  • Product strategy
  • Safety

Clinical guardrails for an AI-enabled product

Challenge
Turning model output into recommendations clinicians can trust takes more than accuracy metrics. It needs clinical context, clear boundaries, and a way to catch failure modes before they reach patients.
Approach
Led product direction that paired AI capabilities with established CDS discipline: grounding outputs in coded clinical data, defining where human review is required, and building clinician-reviewed evaluation scenarios into release criteria.

Outcome

A roadmap and release process that clinical, data science, and engineering teams could align on, with safety and explainability treated as product requirements from the start.

04About

Clinical judgment, product discipline.

MRH Solutions is the independent consulting practice of Matt Hiott, PharmD, MBA.

I started in retail pharmacy and clinical operations, where I saw how medication decisions actually get made: under time pressure, with incomplete information, and with a patient waiting. That vantage point has shaped everything since.

For roughly the past decade I’ve worked in clinical decision support. I’ve built more than 100 guidelines delivered across Epic and Cerner environments, worked hands-on with FHIR, CDS Hooks, RxNorm, and SNOMED CT, and moved into product management leadership, guiding the teams that turn clinical evidence into software.

Today I help organizations apply that same rigor to clinical AI and decision support, so what they ship works in real clinical workflows, not only in a demo.

Matt Hiott

PharmD, MBA · Founder, MRH Solutions

Training
Doctor of Pharmacy (PharmD), MBA
Focus
Clinical AI, clinical decision support, product leadership
EHR environments
Epic, Cerner (Oracle Health)
Standards
FHIR, CDS Hooks, RxNorm, SNOMED CT
Foundation
Retail pharmacy and clinical operations

Have a clinical AI or decision support initiative in motion?

Whether you’re validating an AI use case, scaling a guideline library, or need product leadership that bridges clinical and technical teams, a short conversation is the best place to start.

  • Advisory & second opinions
  • Project-based design and build
  • Fractional product leadership
Start a conversation or email matt@mrhsolutions.co

05Contact

Let’s talk about what you’re building.

Share a little about your organization, the problem you’re working on, and your timeline. I’ll follow up by email to find a time to talk.

Prefer email?

matt@mrhsolutions.co

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