For health systems, CINs, and provider groups
Value-based performance, guideline adoption, fewer avoidable hospitalizations: the results you are held accountable for often rely on the decisions your physicians and APPs make every day. We help you see those decisions clearly, give your clinicians feedback they trust, and track how care and value improve.
How an engagement runs
Every step uses the same realistic simulated patients, so the differences we measure are differences in decisions, not in patients. First results arrive in weeks.
You pick the clinical areas tied to your quality and ROI priorities. We build realistic simulated patients around the decisions that matter to you.
Your physicians and APPs care for the same patients. We record what they order, how they document, which treatments they choose and when they refer, and score each decision against the evidence-based guideline.
Each clinician gets feedback on every decision, with the evidence behind it, and sees how their care compares with the group’s. CME and MOC credit come with the work.
After each season, the group sees its results and talks through the highest-impact decisions. Because everyone cared for the same patients, the conversation is about the care, not an argument over data sources and attribution.
Each new season of cases shows what changed, decision by decision. We report the change in practice and what it means for cost and quality.
What you get
The same validated engagement approach drives all three formats. Pick the one that fits your priorities and your clinicians.
Eight to twelve full patient cases a year, in three seasons. Each takes 10 to 12 minutes and asks for six to eight decisions, every one scored against the evidence with personal feedback. Group results and a group discussion after each season.
CME, with an MOC option.
Short daily clinical puzzles, each under five minutes, scored against the guidelines with the reasoning and the citation. The lightest way to keep a group in the evidence between full cases.
CME, with an MOC option.
Built for clinical teams, for example a physician, an APP, a nurse, a case manager and a clinical pharmacist, each responsible for the care in their own sphere. Simulated team members, driven by AI, play the other roles, so the cases show where communication and coordination break down.
A new platform. We are looking for pilot partners.
All content is independent of any commercial interest. CME is offered through joint providership with an accredited provider, with an MOC option.
What it takes
A few hours a year, in short increments, for the cases, plus the group discussions.
Where this approach has worked
We have published results with this approach across these specialties and improvement goals, and we build cases for new ones.
How we know it works
Our published work with health systems, clinically integrated networks and provider groups covers primary care, hospital medicine and oncology, and includes a national randomized trial of the measurement and feedback approach. Where a paper followed the change into the system’s own cost, quality or utilization data, the card says so.
Clinical training Observational studyReal-world results
Primary care physicians and APPs across Henry Ford Health trained on simulated COPD patients. Their real patients with COPD then had 27% fewer emergency visits, 8% fewer hospitalizations and 37% fewer pulmonology referrals than the patients of colleagues who were not invited, about $1.3 million in savings to the system.
With Henry Ford Health, Henry Ford Physician Network, Jackson Health Network
The American Journal of Medicine, 2025
Muma B, Keteyian C, Kolde D, Drake S, George D, Foust M, Fried S, Elsberg J, Thomas S, Johnston L, Kulawczyk A, Paculdo D, Cooney I, Peabody J, Burgon T. Am J Med. 2025;138(10):1360-1365.e2. doi:10.1016/j.amjmed.2025.05.032
Clinical training Observational study
Primary care physicians paired with a pharmacist improved their treatment scores on simulated patients more than physicians working alone, with the largest gains in stopping sulfonylureas (+16.2%) and prescribing SGLT2 inhibitors (+23.1%). The collaboration helped most with polypharmacy and deprescribing.
With Walgreens
JAPhA Practice Innovations, 2025
Chesler A, Puckett-Beasley J, Shakouri A, Borowski M, Eustis D, Paculdo D, Cooney I, Vergara JP, Fields C, Burgon T. JAPhA Pract Innov. 2025;2(2):100031. doi:10.1016/j.japhpi.2025.100031
Clinical training Randomized validation study
A national randomized trial in which practicing primary care physicians cared for eight weekly simulated cases with real-time evidence-based feedback and peer benchmarking. Three in four completed at least six cases, and evidence-based decisions improved across conditions, including diabetes (+8.3%) and quality measures such as diabetes eye exams (+22%) and asthma medications (+33%).
With a national sample of PCPs
Journal of Medical Internet Research, 2021
Burgon T, Casebeer L, Aasen H, Valdenor C, Tamondong-Lachica D, de Belen E, Paculdo D, Peabody J. J Med Internet Res. 2021;23(12):e31042. doi:10.2196/31042
Clinical training Observational studyReal-world results
245 hospitalists at 15 Novant Health facilities worked through simulated COPD cases over 16 weeks. Quality-of-care scores rose 10.5%, and in the real-world data COPD pharmacy costs fell 19%, with an annualized 233 fewer inpatient days, 371 fewer revisit days and nearly $1 million in inpatient savings.
With Novant Health
Healthcare (Basel), 2021
Strong J, Weems L, Burgon T, Branch J, Martin J, Paculdo D, Tamondong-Lachica D, Cruz J, Peabody J. Healthcare (Basel). 2021;9(10):1267. doi:10.3390/healthcare9101267
Clinical training Observational studyReal-world results
Hospitalists at eight AdventHealth hospitals cared for simulated sepsis and heart failure patients, with feedback, over two years, and were compared with six hospitals that did not take part. Their evidence-based care scores rose nearly 8%, length of stay fell faster than in the comparison group, and $2.4 million in savings was attributable to the project beyond system-wide improvements.
With AdventHealth
Journal of Hospital Medicine, 2019
Yurso M, Box B, Burgon T, Hauck L, Tagg K, Clem K, Paculdo D, Acelajado MC, Tamondong-Lachica D, Peabody JW. J Hosp Med. 2019;14(9):541-546. doi:10.12788/jhm.3220
Clinical training Observational studyReal-world results
Primary care clinicians in a Connecticut ACO took six rounds of simulated cases with individual and group feedback over two years. In the cases, evidence-based quality scores rose 27% and unneeded testing fell 55%; their real ACO quality measures improved beyond the comparison group, with more than $4.8 million in calculated savings on unneeded tests and specialist referrals.
With ProHealth Physicians, Aetna Accountable Care Solutions
Population Health Management, 2019
Burgon TB, Cox-Chapman J, Czarnecki C, Kropp R, Guerriere R, Paculdo D, Peabody JW. Popul Health Manag. 2019;22(4):321-329. doi:10.1089/pop.2018.0111
Clinical training Observational studyReal-world results
103 medical oncologists in a clinically integrated network cared for simulated breast and lung cancer patients every four months over six rounds, with feedback against evidence-based guidelines and their peers. Overall quality scores improved 11.9%, evidence-based chemotherapy regimens rose nearly 10 percentage points, and unnecessary test ordering fell 25%; in the network's own claims data, metastatic imaging workups for early-stage breast cancer declined in step with the simulations.
With Advocate Physician Partners
Journal of Oncology Practice, 2019
Richards JM, Burgon TB, Tamondong-Lachica D, Bitran JD, Liangco WL, Paculdo DR, Peabody JW. J Oncol Pract. 2019;15(12):e1076-e1084. doi:10.1200/JOP.18.00754
Clinical training Observational studyReal-world results
A multidisciplinary breast cancer team at an NCI-designated cancer center measured its care decisions on simulated patients, built its own breast cancer pathways, and received individual and group feedback on adherence. Overall quality scores rose from 47.5% to 61.1%, diagnostic accuracy improved by 22.1%, and unnecessary test orders fell by an estimated $305 per patient case.
With Huntsman Cancer Institute, University of Utah
Clinical Breast Cancer, 2019
Colonna S, Sweetenham J, Burgon TB, Buys SS, Lynch R, Au T, Johnson E, Kubal T, Paculdo D, Acelajado MC, Peabody JW. Clin Breast Cancer. 2019;19(2):e376-e384. doi:10.1016/j.clbc.2018.12.010
Who this is for
Let’s spend thirty minutes exploring your priorities, what a first season would look like, and whether this fits.