Our Take
A clinical workflow integration that works only if adoption actually happens; the real test is whether health systems beyond Northwell will flip the switch.
Why it matters
Firearm injuries are the leading cause of injury-related death in the US, and hospitals are where most treatment occurs. Embedding risk screening into the EHR workflow at the point of care removes friction between identification and intervention.
Do this week
EHR administrators: audit your current firearm safety protocols against Northwell's screening criteria before May to decide whether adoption fits your violence prevention strategy.
Northwell Health's screening tool ships in Epic
Northwell Health has integrated a firearm injury risk screening tool into Epic's electronic health record system, available as of May for any organization that chooses to deploy it. The tool was developed through an NIH-funded research study called "We Ask Everyone."
The screening identifies patients at risk of firearm injury, delivers gun locks to flagged patients, and routes them to hospital-based violence intervention programs. It also collects data on firearm-injured patients for research purposes.
Dr. John D'Angelo, president and CEO of Northwell Health, framed the tool as a workflow integration: "The most effective interventions are those that integrate seamlessly into a clinician's workflow and allow you to connect with patients in real time."
Prevention at the clinical touchpoint
Hospitals and emergency departments are the primary treatment sites for firearm injuries (per CDC data), which makes the healthcare system a logical place to intervene before repeat injury or escalation. Kaiser Permanente Washington demonstrated this model last year by incorporating firearm access screening into its suicide prevention programs and offering free gun locks.
The gap so far has been workflow friction. A screening tool that requires manual lookup or separate documentation creates a barrier to adoption. Embedding it into the EHR where clinicians already document patient encounters removes that friction.
The real constraint is adoption. The tool is available to organizations that "choose to adopt it," meaning uptake will depend on each health system's existing violence prevention infrastructure, staff buy-in, and tolerance for screening conversations at intake.
What health systems should do now
If your organization uses Epic and has an active violence prevention or emergency medicine program, audit your current firearm safety protocols against Northwell's screening framework. You need to know whether this tool expands your existing capability or duplicates what you already do.
The second decision is resource readiness. Screening identifies risk; intervention requires staff capacity. Before adoption, confirm that your violence intervention program can handle the referral volume that screening will generate.
Third, plan for staff training. Clinicians need to know what triggers the tool, how to interpret results, and what to do when patients decline the intervention. A tool that sits unused in Epic is worse than no tool.