By 2020, Cone Health was ready to update its insulin management approach. With the sunset of their prior insulin dosing software, leadership evaluated options and selected EndoTool for its ability to deliver patient-specific insulin dosing.

Unlike other algorithms, EndoTool incorporates renal function, weight, steroid use, and diabetes type. This was a decisive factor for Cone Health.

When Cone Health launched EndoTool across five hospitals, success came from a clear change management plan:

1. Build Super Users in Every Unit

Designated champions were trained within each department to support adoption and provide real-time guidance.

2. Create Custom Learning Modules

Instead of relying on generic training, Cone Health developed modules tailored to their order sets and workflows ensuring relevance and clarity for staff.

3. Deliver Specialty-Specific Education

Training was customized for ICU, ED, Women’s Health, and progressive care teams so each group understood how EndoTool would fit into their daily responsibilities.

4. Leverage Epic Integration for Nurse Buy-In

The final driver of adoption was seamless integration with Epic. Nurses could launch EndoTool directly within the EHR, eliminating double documentation and keeping workflows aligned in real time. This convenience proved to be one of the biggest factors in staff acceptance.

For nurses, EndoTool became not just another clinical decision support system but an everyday tool that simplified decision-making. It gave clear, specific recommendations for insulin dosing and when to check the next glucose value, reducing guesswork and stress at the bedside.

“EndoTool is integral to our workflow. We need it.”

Pat Stramoski RN, MSN, CCRN

Clinical Nurse Educator

Providers embraced the change as well. EndoTool is now fully integrated into Epic order sets, making its use standard practice across the health system.

Since implementation, Cone Health has seen consistently low hypoglycemia rates across patient populations.

The team has particularly valued EndoTool’s DKA mode, which guides nurses not only on blood glucose but also on key acidosis markers such as beta-hydroxybutyrate and CO₂. This ensures care is tailored to the underlying condition rather than focusing solely on glucose numbers.

Additional safeguards like reminders for potassium checks, dextrose administration, and resolution criteria further support nurses in delivering consistent, high-quality care. These guardrails have helped reinforce Cone Health’s culture of safety while reducing risk at the bedside.

For Cone Health, EndoTool has become more than a clinical decision support tool, it’s part of the culture of care. From reducing hypoglycemia to supporting complex transitions in cardiac surgery, the system continues to expand what’s possible.

Their commitment to innovation has not only lowered risk and improved outcomes but also set a new standard for how health systems can deliver patient-specific care at scale.