Operational detail from the RWJBarnabas deployment shows the Epic Deterioration Index continuously reading vitals, labs and nursing assessments, recalculating risk every fifteen minutes and paging rapid-response teams at top tiers. Nearly half of intervention patients generated alerts; not every alert triggered a full team activation. It matters because workflow integration — timing, paging, staffing — explains outcome changes as much as the model itself. Caveat: hospitals without comparable response capacity may not see the same mortality shift from software alone.