Building a Patient Readiness Platform
Automating Healthcare's preflight checklist
Building a Patient Readiness Platform
Every healthcare organization performing complex procedures needs to understand a patient’s current clinical condition, both on its own and in the context of the specific procedure a provider wants to perform.
This requirement is universal across healthcare delivery. The implementation of it varies significantly.
What is Patient Readiness?
Patient readiness means determining whether a patient’s current condition is sufficient to safely proceed with a specific procedure. It’s deliberately broad because it has to cover a lot of ground:
Physical status
Medications
Procedural requirements
Logistical requirements
Physician preferences
Physical Status
This includes the concrete medical data: lab results, vital signs, imaging scans, current diagnoses, and recent health events.
For surgical patients, you’re also assessing cardiac risk, lung function, nutritional status, and blood sugar control. All the things that determine whether someone can handle the physical stress of a procedure.
Medications
Medication management is trickier than it sounds. Medications need to be checked against the current guidelines and cross-referenced between both facility and physician preferences. Some drugs need to be held, some continued. Some require additional testing first to see if it’s safe.
And here’s what makes this complicated: medical guidelines change as research advances. Standard guidelines five years ago might be outdated today.
Procedural Requirements
These are required tests, approvals, and prep work that need be completed before the procedure can take place, as the name suggests, This list isn’t universal and depends heavily on the procedure itself, the patient’s risk factors, and how those two play together, how the facility operates, and the preferences of the surgeon and anesthesiologist running the show.
Logistics
Logistical requirements cover issues such as patient availability and recovery planning. You’d be surprised how often patients get cancelled because they don’t have a ride home.
Physician Preference
The final factor is provider preference. Physician groups are called practices, and we’d argue the term is not coincidental. Like athletes and artists, medical professionals have their own styles and preferences. These shape the care plan and influence everything from preparation through execution.
The Output is Simple. The Process is Not.
The frustrating part? After all this complexity, patient readiness boils down to three options: go, delay, or cancel.
Knowledge Isolation
Critical process knowledge often lives with a small number of experienced staff. When these people leave or call in sick, process reliability drops.
Integration Gaps
The information you need for readiness decisions exists across multiple systems. Someone has to manually aggregate, reconcile, and interpret all that data.
Orchestra: Automating Patient Readiness
Orchestra is a platform that automates patient readiness evaluation. It integrates with existing clinical workflows and applies organization-specific rules to determine who’s ready and who’s not.
Data Aggregation
Orchestra connects to your existing clinical systems and pulls together everything needed for readiness evaluation. We combine labs, prescriptions, orders, scheduled appointments, documentation, as well as structure unstructured sources like doctor’s notes, patient preference, and imaging together.
Rule Application
The system applies your organization’s clinical rules and risk thresholds to patient data. These are your guidelines, not someone else’s standards imposed from outside.
Status Determination
For each patient, Orchestra produces a readiness assessment that determines which criteria the patient meets. Which are still outstanding, and where the patient has breached the threshold.
Exception Surfacing
When issues need human attention, the system routes them to the right staff with relevant context. No more manually checking on every patient.
The Complexity Spectrum
Not all patient readiness evaluations are created equal. They range from simple to highly complex.
Complexity depends on procedure risk, the number of clinical domains involved, and how much coordination is required.
Let’s look at both ends of the spectrum.
Low Complexity: Blood Donation
Blood donation sits at the simpler end, when you donate blood a donation centers screen for defined exclusion criteria before collection:
Iron levels, to check for anemia
Recent travel
Current medications
Vital signs
History of specific medical conditions
All of this can generally be done on site or remotely with high accuracy and low cost. Because the procedure is complex and the guidelines are straightforward, we’ve been able to scale donating blood nationally as somethign that can occur easily without an appointment during a lunch break.
High Complexity: Orthopedic surgery
At the other end of the spectrum we have something like orthopedic surgery, which is generally where we spend most of our time.
Preparing someone for total joint replacement requires extensive preparation across several disciplines.
Cardiac/Pulmonary Assessment
Complex surgeries place enormous strain on the body, which stresses most systems including your heart and lungs. To understand your body’s ability to withstand this stress tests like EKGs and chest X-rays are often to used to develop an understanding of those systems.
Pulmonary Evaluation
This might include lung function testing and chest imaging. Patients with chronic issues need to be identified so they can optimized prior to surgery.
Medication Management
This requires coordination across multiple drug classes:
Anticoagulants need specific hold periods based on how long the drug stays in your system and the patient’s clotting risk
Antiplatelet agents are managed based on bleeding risk and why the patient takes them
Blood pressure medications are continued or stopped based on anesthesia protocols
Diabetes medications get adjusted for fasting
Herbal supplements and over-the-counter medications are reviewed for surgical risks
Preoperative Testing
Testing follows a schedule tied to the planned surgery date. Lab values obtained too early must be repeated. Testing done too late might delay surgery.
Clearances
Specific system assessments provide more detailed recommendations on how to proceed with the procedure that can be drawn upon for a final decision. Each of these are respective, and sometime pejoratively, know as clearances. These might be required from cardiology, pulmonology, endocrinology, or other specialties, depending on the patient’s other health conditions. Primary care doctors often document that the patient is medically optimized.
Who’s Involved in Complex Readiness?
Preparing a patient for major surgery involves a lot of people:
Surgeons define procedure-specific requirements and make final calls about patient suitability.
Surgical coordinators and preoperative nurses track completion status, gather missing information, and communicate with patients.
Anesthesiologists evaluate airway anatomy, cardiac and pulmonary function, and medication considerations.
Primary care physicians provide medical history, manage chronic conditions, and document optimization.
Medical specialists address specific risk factors in their domain—cardiologists for heart risk, lung doctors for breathing optimization, and so on.
Pharmacists review medications and identify potential interactions or concerns.
Laboratory and imaging staff complete time-sensitive testing.
Schedulers coordinate operating room time, bed availability, and staffing.
Case managers address post-discharge needs and discharge planning.
Patients and caregivers complete assigned prep tasks, provide updated information, and confirm they understand instructions.
Each person operates within their own system and workflow. Information exists across multiple platforms.
The surgical coordinator typically functions as the central hub, manually tracking what’s done and what’s not, following up on outstanding items, and maintaining awareness of overall readiness.
This model is labor-intensive. It depends heavily on individual coordinator capacity and institutional knowledge.
It doesn’t scale well with patient volume.
What Happens When the Process Fails
Patient readiness failures have real consequences.
Same-Day Cancellations
These happen when readiness issues are identified too late. The operating room slot is lost or underutilized. The patient must be rescheduled, repeating parts of the prep process.
Studies estimate same-day cancellation rates of 5-10% at many institutions. Inadequate preoperative preparation is a leading cause.
Procedural Delays
These occur when outstanding items are found on surgery day, but can be addressed quickly. The case starts late, affecting all subsequent cases on the schedule—staff overtime increases. Patient and family experience suffers.
Suboptimal Patient Condition
This happens when fixable issues aren’t identified or addressed before surgery. Patients with uncontrolled diabetes, unoptimized anemia, or poorly managed heart conditions face higher complication rates.
Adverse Events
In severe cases, missed contraindications can cause preventable harm. Medication interactions, unrecognized allergies, or unidentified health conditions can result in serious problems.
Staff Burden
As coordinators manage increasing patient volumes with manual processes, the burden accumulates. Turnover in these roles creates knowledge gaps and training requirements.
These consequences are largely preventable. You just need to identify readiness gaps early enough to fix them.
Application
Orchestra addresses the operational challenge of patient readiness by providing automated, configurable evaluation against your organization’s criteria.
The platform doesn’t replace clinical judgment. It won’t make decisions for you.
What it does do is provide clinicians and coordinators with consolidated information and systematic status assessment. This lets them focus their attention on items that actually require human decision-making.
Patient readiness is a prerequisite for procedural care. It’s the first question you need to answer.
Orchestra provides the infrastructure to answer it consistently, every time.