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Hacker News
6/10

Screen & Substance

An EHR-integrated screening assistant for cardiologists and primary care that prompts clinicians to ask about cannabis and other substances during intake, auto-flags elevated cardiovascular risk, and logs the conversation for longitudinal tracking.

Target user

Cardiologists, internists, and primary care physicians building intake workflows for younger patients

Features
  • Smart intake prompts that normalize cannabis questions alongside smoking and alcohol (per ACC's recommended workup)
  • Risk overlay that combines substance disclosures with patient EHR data to highlight flagged cardiovascular concerns
  • Conversation note generator that produces compliant chart entries capturing dosage, frequency, and method
  • Cohort dashboard showing a practice's at-risk patients by substance profile for population health review
Why now

The ACC's lead investigator explicitly called for cannabis screening to become standard alongside cigarette screening, but most EHR templates still don't include structured cannabis fields — a clear workflow gap.

Signals · overall 6/10
Demand
7/10

ACC's lead investigator Kamel explicitly called for cannabis screening to be standard alongside cigarette screening (Mar 2025 JACC), and an Epic SBIRT implementation is already being piloted in LA primary care clinics, confirming real clinical demand.Cannabis Use Substantially Increases Risk of Heart Attack - ACC Journal Scan (2025)Screening and Brief Intervention for Cannabis Use in Primary Care in a Health System - Annals of Family Medicine

Whitespace
6/10

Academic Epic-based cannabis SBIRT implementations exist (UCLA/LA clinics), but no vendor-built, cardiology-specific cannabis-CV-risk CDS product surfaced in marketplace searches; large ambient scribes (DAX, Abridge, Nabla) capture substances passively but lack structured CV-risk flagging.Screening and Brief Intervention for Cannabis Use in Primary Care - Annals of Family MedicineAmbient AI Scribe Comparison Guide 2026 - MedEquip Directory

Monetization
5/10

Cardiology practices spend $100-300/clinician/month on AI scribes, indicating willingness to pay for workflow tools, but hospital systems often bundle CDS into Epic/Cerner contracts, and a narrow single-risk add-on competes with bundled ambient scribe platforms.Best AI Medical Scribes 2026: 15 Physician-Reviewed ToolsAmbient AI Scribe Comparison Guide 2026

Longevity
8/10

Cannabis legalization continues to expand and a major 2025 ACC publication explicitly elevates cannabis to a standard CV risk factor, creating durable regulatory and clinical guideline tailwinds.Cannabis Use Substantially Increases Risk of Heart Attack - ACC Journal Scan (2025)2025 ACC/AHA Clinical Practice Guidelines Core Principles

Feasibility
4/10

EHR integration requires Epic App Orchard/Cerner code-appellate certification and HL7/FHIR work; FDA may classify CV-risk flagging as non-device CDS but borderline, and standalone cardiology templates risk being subsumed into ambient scribes.

Cannabis users face substantially higher risk of heart attack (2025) · 124 points · 174 commentsHacker News · 2026-07-05 (19d ago)