Trusted Decisions at the Bedside

A medical calculator is only as useful as the patient information behind it. VA clinicians needed decision support without repeatedly copying information from the electronic health record into separate tools. Differences in terminology, units and local data capture added complexity: a sound equation could still produce a misleading result if supplied with the wrong observation. As VA modernized its health records, the application also needed to work across changing clinical environments. The goal was to bring relevant patient data, published evidence and clinician judgment together where care decisions happen.

Working on Coforma’s CDS Applications team, Bracari designed and developed Medical Calculators and provided technical leadership, engineering and automated testing. We used SMART on FHIR and VA Lighthouse APIs to bring patient context and clinical data into the application, reducing the need to re-enter information already held in the record.

Our engineers worked with clinical subject matter experts to translate published evidence into calculator-specific inputs, terminology mappings, time windows, validation rules and clinical guidance. Clinicians can inspect and modify populated values, see when observations were recorded and review alerts before interpreting a result. This makes the basis of the calculation visible while preserving clinical judgment.

We built the application with a Java/Spring backend and React interface, automated testing and cloud deployment. Operational analytics, clinician feedback and ongoing clinical review guide improvements as evidence and VA data evolve.

In August 2026, Medical Calculators generated more than 32,000 calculated results, demonstrating use within clinical workflows. The application offers more than 12 calculators, giving clinicians reusable tools for assessing patient information at the point of care. Populated inputs, visible source information and clinician review reduce reliance on manual transcription and make calculations easier to scrutinize. For VA, this creates a repeatable path from clinical evidence to practical decision support. For the clinician, it brings the patient information and the calculation together in one workflow, with the ability to review both before acting.

• Clinical application development
• SMART on FHIR
• Interoperability
• Clinical data validation
• HCD
• Automated testing
• Cloud engineering