Procedure approval across committees

How do we get a procedure approved across the committees that must each decide, with the case file assembled once, routed in order, and every decision recorded with who decided?

Build the case once and route it through the committees in the order the policy sets. When a procedure needs approval (a high-cost or novel procedure, an off-protocol treatment, a transplant listing, a case the policy reserves), Callvu assembles the case file from the EHR and the requesting clinician (the clinical summary, the indication, the evidence, the alternatives, the costs, the consents, the supporting results), classifies the committees that must decide and their order (the clinical review, the ethics committee, the tissue or transplant committee, the finance or utilization committee), chases what each committee's checklist requires before it sits, puts the case to each committee in the Decision Desk with only the allowed outcomes, records every decision with who decided and the conditions, and writes the final approval or the denial with its conditions to the EHR against the procedure. Live at Ministry of Health, under national rules outside the US.

Live at Ministry of HealthComplex: multi-party handoffsCallvu moves: chase and verify, decide, write back

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Last updated November 7, 2026.

The problem today

The case went to three committees as three different emails, and the ethics committee decided on a version the surgeon had already revised.

Today, without Callvu

Some procedures need more than one approval: a clinical review, an ethics opinion, a tissue or transplant committee, a finance decision for a high-cost device or an exceptional funding. Each committee has its own secretary, its own meeting, its own checklist and its own version of the file. The case ages between meetings, decisions are recorded in minutes nobody can find, and the procedure date moves.

The approvals are a chain with rules: which committees must decide for this procedure type, in what order, what each must see before it sits, who may vote, what outcomes are allowed, and how the conditions attach. The file is one file. Each decision is a record with a person, a date and a reason. The policy says so; the process should enforce it.

A case that reaches each committee complete, in order, with the previous decision attached, is a case that gets decided.

How it runs

From the requestto the system of record.

A clinician requests approval for a procedure the policy reserves for committee decision. Callvu opens the case from the request.

Requesting clinician: Supplies the indication, the evidence and the answers to the committees' questions through a link.
Committees and their chairs: Each decides in the Decision Desk with the case and only the allowed outcomes.
Patient or representative: Is informed and consents where the approval requires it, through the consent process.
Callvu: Assembles, classifies the committees and the order, chases the checklists, routes, records every decision and writes.

Assemble the case
The case file is assembled from the EHR (the clinical summary, the diagnosis and the staging, the relevant results, the prior treatments, the consents on file) and from the clinician through a link (the indication, the evidence base, the alternatives considered, the expected benefit and risks, the costs and the device or drug details, the urgency); the procedure type classifies the committees required and their order under the policy.
Chase and verify each committee's checklist
Each committee's checklist (a second opinion, a specific result, a cost estimate, the patient's consent to the referral, an ethics consult note) is chased from its holder before the committee sits, read and checked; the case shows the committees' sequence and what each is waiting for, and the clinician sees the status.
Decide, committee by committee
The case goes to each committee in the Decision Desk in order with the complete file and the prior committee's decision attached, and only the allowed outcomes (approve, approve with conditions, request more information, defer to the next meeting, or decline with the reasons); the chair records the decision with the members present, the vote where the policy requires it, the conditions and the reasons; a condition becomes a chase to its owner, and a request for information returns the case to the clinician with the specifics.
Write back
The final approval with its conditions and validity, or the denial with the reasons and the appeal path, is written to the EHR against the procedure with the full decision record (each committee, each decider, each date, each reason), the scheduling and the consent processes read it, and the committees' registers are written from the same record.

Where it ends: One case file went through every committee the policy requires, in order, complete, with each decision recorded with who decided and why, and the EHR holds the approval with its conditions. The Decision Trace shows the committee classification, each checklist and each decision; the Audit Trace shows the assembly, the chases and each committee's record with time.

Runtime enforcement

What is enforcedwhile the work runs.

The regulations preloaded in Callvu Studio and the bank's own policies, applied as steps that run, not lines in a binder. A step that breaks a rule does not run, so a completed run was compliant.

Regulations

US requirements shown. Ministry of Health runs this process under national rules outside the US; Callvu loads each market's rules as policies the same way.

Medical staff and committee governance (42 CFR 482.22 medical staff Conditions of Participation; the Joint Commission MS and LD standards; the hospital's bylaws and committee charters): The medical staff's committees decide under the bylaws and their charters, which set the membership, the quorum, the voting, the conflicts of interest and the record of decisions; the hospital must document committee actions and their basis; the process applies the charters as the routing and the outcome rules.
Ethics committee and consent standards (42 CFR 482.13 patient rights; the Joint Commission RI.01.01.01; the hospital's ethics consultation policy): An ethics review of a treatment decision follows the hospital's policy with the patient's or the representative's participation and the consent to the procedure obtained through the consent process; the ethics opinion is recorded with the case.
Utilization and financial approval rules (the utilization review plan under 42 CFR 482.30; the hospital's value analysis and exceptional funding policies; the payer's authorization where coverage applies): A high-cost or non-covered procedure requires the utilization review and the financial approval under the hospital's plan, and the payer's authorization where coverage exists, which the committee sequence includes.

Company policies

One case file for all committees, assembled from the EHR and the clinician once.
The committees and their order come from the policy for the procedure type; no committee sits without its checklist complete.
Every decision is recorded with the deciders, the date, the reasons and the conditions, and the registers are written from the record.
The EHR is the system of record for the approval and its conditions.

Controls

Case assembly from the EHR and the clinician.
Committee and order classification by policy.
Checklist chases before each committee.
Decision Desk per committee with required outcomes and decision records.
Condition chases and information requests.
EHR write and register update.

Clocks and deadlines

Committee cycle: Each committee's meeting schedule, with the case complete before it sits and the urgency rule for expedited decisions.
Information requests: Returned to the clinician with the specifics and chased on the schedule.
Approval validity: The period and the conditions on the approval, read by scheduling.

Documents and checks

The case file with its sources
Each committee's checklist and its items
Each committee's decision record
The conditions and their fulfilment
The EHR record and the registers

In the Decision Trace

The committee classification and the order.
Each checklist and its completion.
Each decision, the deciders, the reasons and the conditions.

In the Audit Trace

The assembly and each chase with time.
Each committee's record with time.
The write and the register entries.

The handoff

Between the front doorand the back office.

The front door

The clinician's request with a link for the indication and the evidence; the patient through the consent process.

The back office

Each committee decides a complete case in order; the secretaries stop assembling emails.

The Decision Desk

Each committee decides in the Decision Desk with the complete file and the prior decision and only approve, approve with conditions, request information, defer, or decline with reasons, recorded with the deciders.

Proof

Live at Ministry of Health.Published results only.

Each result is a published claim, with its code on agents.callvu.com, where its status, source and last verified date are kept.

The Ministry of Health hospital network runs 23 hospitals on Callvu and keeps adding more, with 3x faster procedure approvals, 78% faster patient consent and more than 1M pages of paper eliminated.

HLT-01 · Self-asserted · verified 2026-11-05

At the Ministry of Health, a process chains up to five patient forms and signatures and ten internal steps; completing one step starts the next, for example surgery consent starts anesthesia consent and sends the procedure to the approving committee.

HLT-02 · Customer-attested · verified 2026-11-05

At the Ministry of Health, Callvu integrated with very old legacy systems at several hospitals, and brings ERP, CRM and EHR data into one experience.

HLT-05 · Customer-attested · verified 2026-11-05

Questions

What buyers ask next,answered plainly.

Which committees decide?

The ones the policy requires for the procedure type, in the order it sets: for example the clinical review, the ethics committee, the tissue or transplant committee and the finance committee; the classification applies it.

What does each committee see?

The one complete case file with its checklist items and the prior committee's decision attached, in the Decision Desk, with only the allowed outcomes.

How are decisions recorded?

Each with the deciders present, the vote where required, the date, the reasons and the conditions, written to the EHR against the procedure and to the committee's register from the same record.

Related processes

Exceptional treatment and funding requests New product and device requests Clinical privilege requests Surgical informed consent, chained with anesthesia consent Try it in the sandbox All healthcare processes

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