Illustrative surgery center · one case, booking to OR
One pathway from booking to OR for surgery centers and the anesthesia groups that cover them. Problems surface while there’s still time to fix them, and anesthesia signs off on only what needs a decision.
BUILT BY PRACTICING ANESTHESIOLOGISTS · PHYSICIAN SIGN-OFF ON EVERY CASE
¹ Childers & Maggard-Gibbons, JAMA Surgery 2018: hospital-based ambulatory ORs, California, FY2014. ² Ferschl et al., Anesthesiology 2005: same-day surgery suite, 16.2% of patients not seen in a pre-op clinic vs 8.4% seen.
An empty slot at an ASC rarely gets backfilled. PeriGate moves the pre-op work to the day the case is booked, and gives each team only its own next step.
Missing records, overdue workups and open questions show up the day the case is booked, while there's still time to fix them.
The chart is confirmed once. Clean sections sign off in one step; only flagged items need a decision, and each one gets its own.
The office sees to-dos and dates, the surgeon sees status, the manager sees readiness across the schedule. Office users never see clinical judgments.
Each section's decision, who signed it and the engine version travel with the note, in a hash-chained audit trail ready for your quality committee and your carrier.
The office books the case and gets a to-do list with dates.
A deterministic, versioned engine computes risk scores and safety checks. AI drafts the narrative.
Anesthesia confirms the chart, decides what's flagged and signs off once. The note is ready for the chart.
Illustrative screens, no patient data. The office board is in design; anesthesia sign-off is live today.
Most pre-op AI either chases paperwork or hands a physician a note to sign. PeriGate runs the safety checks, shows its work, and keeps the physician in charge.
| What to compare | PeriGate | Scheduling-first AI | Note-first AI |
|---|---|---|---|
| Built for surgery centers and the anesthesia groups that cover them | Yes | Mostly hospital systems | Varies |
| Clinical logic: a deterministic, versioned engine for risk scores and safety checks | Yes | Not its job: calls, faxes, scheduling | Rarely disclosed |
| Physician sign-off, each section's decision recorded | Yes | Not described | One signature for the whole note |
| Flagged findings can never be bulk-accepted | Yes | — | — |
| Hash-chained audit trail on every note, with the engine version | Yes | — | Rarely described |
| Booking-day to-dos for the surgical office | In design | Their strength | — |
Categories, not companies. Ask any vendor to show you each row.
Risk scores and safety logic come from versioned rules.
Never learns from live clinical data. Changes ship only as new versioned releases.
Every section records who reviewed it and what they decided.
PeriGate is architected as clinician-directed clinical decision support: the physician independently reviews the basis for every recommendation and attests every output before it is used. This two-gate design is aligned with the clinical decision support criteria described in Section 3060 of the 21st Century Cures Act. The system is conservative by default — where uncertainty exists, it recommends more workup and more monitoring, never less.
A live walkthrough on an illustrative case, or a seat as a validation and design partner. No patient data, no marketing pitch.
Built by the people who sign the chart: Michael Grinn, MD MPH, a practicing cardiac anesthesiologist, with technical co-founder Farhan Baluch.