• Customer Stories

Why CaroMont Health Made EndoTool a Systemwide Standard for Insulin Dosing

About CaroMont Health

CaroMont Health is an independent, not-for-profit healthcare system serving the greater Gaston County region in North Carolina. The system includes CaroMont Regional Medical Center in Gastonia and its newest facility, CaroMont Regional Medical Center-Belmont, opened in 2025.

In 2009, CaroMont Health’s flagship hospital in Gaston made a forward-looking move to replace paper-based insulin protocols with EndoTool, a computerized insulin dosing system. This marked the beginning of a clinical mindset shift. From the start, the CaroMont team saw EndoTool not as a replacement for their protocols, but as a partner in better care.

L-R: Misty Amos, RN Systems Analyst, Zach Ruffner, IT Project Manager, Daniel Baucom, Epic Applications Coordinator, Johanna Ramirez-Rodriguez, Manager of Diabetes Services, Shannon Williams, Manager of Clinical Informatics, April Willis, Director of Clinical Informatics, Michael Gissy, RN Systems Analyst

Integration and Expansion for Scaling Success

By 2016, that partnership deepened. CaroMont integrated EndoTool into its Epic EHR, streamlining workflows and achieving smoother bedside care. Behind the scenes, it took a collaborative team to challenge the status quo and align on a safer, more consistent insulin dosing strategy.

When CaroMont opened its second hospital in Belmont in 2025, the team ensured EndoTool was built into operations from day one. Their commitment to consistency wasn’t just logistical, it was clinical. They knew that expanding technology is one thing. Ensuring adoption is another. Their approach emphasized clinical input, training, and proactive planning to help replicate success across campuses and standardize best practices across teams.

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“Nurses no longer have to rely on printed algorithms. EndoTool walks them through each step, especially during hypoglycemia, when timing and precision are critical.”
April Willis, MSN, RN, NI-BC
Director of Clinical Informatics

A 0.008% Severe Hypo Rate Speaks Volumes

At CaroMont Health, each EndoTool upgrade is seen as an opportunity to improve care, not just a software update. The team actively reviews performance data, refines workflows, and adapts protocols to meet evolving patient needs. That hands-on approach has delivered measurable results.

In 2024, CaroMont achieved a severe hypoglycemia rate of just 0.008%, a testament to their ongoing commitment to safer, smarter glycemic management.

With every upgrade, they continue to reduce risks, shorten time to target, and raise the standard of care across their system.

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“We like how EndoTool looks at the whole patient, not just blood sugar, but also weight, type of diabetes, creatinine levels, and previous insulin dosing.”
Johana Ramirez-Rodriguez, MSN, RN, CDCES, CPT
Diabetes Services Manager

Strengthening Cross-Team Confidence and Collaboration

At CaroMont Health, innovation goes beyond software, it’s about empowering the people who use it. For their team, EndoTool has become more than just a clinical tool; it’s a bridge between disciplines.

Nurses gain real-time guidance that supports confident bedside decisions. Physicians trust its data-driven recommendations and appreciate the reduced need for manual insulin orders. The platform also streamlines transitions from IV to SubQ insulin and helps standardize care across departments.

It’s the combination of reliable technology and collaborative support that reinforces CaroMont’s trust in Monarch.

What Others Can Learn from CaroMont’s Adoption Journey

  1. Start with a clinical mindset shift
    Position EndoTool not just as a tool, but as a partner in safer, more confident care.
  2. Build trust early and across disciplines
    Nursing, informatics, diabetes care, and IT all played a role in building systemwide alignment.
  3. Integrate EndoTool into existing workflows
    Embedding EndoTool within Epic helped reduce friction, streamline documentation, and improve bedside efficiency.
  4. Treat expansion as an opportunity to refine
    Rolling EndoTool out at a second facility wasn’t a copy-paste exercise — it was a chance to optimize protocols, improve training, and reaffirm consistency.
  5. Track and share results
    A severe hypoglycemia rate of just 0.008% is more than a stat – it’s proof that trust, collaboration, and the right tools make better outcomes possible.

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“Monarch customer support is quick to respond, and I like always knowing there’s someone I can reach out to if I have concerns.”
Johana Ramirez-Rodriguez, MSN, RN, CDCES, CPT
Diabetes Services Manager

Closing Thought: A Model for Change-Driven Adoption

CaroMont’s journey with EndoTool offers a practical lesson for any system navigating change: successful adoption doesn’t just come from technology. It comes from building trust, creating space for clinical voices, and committing to consistency – one hospital, one team, and one patient at a time.

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