Why we exist
Systems of record ran the last era of surgery centers. Systems of optimization will run the next.
Every year, more surgery moves out of hospitals and into ambulatory surgery centers — over 22 million procedures, a $60 billion market, growing on every structural tailwind healthcare has. And most of it still runs on software designed to file what happened yesterday.
The gap nobody built for
Walk into a well-run ASC and you’ll find excellent clinicians, a capable administrator — and a technology stack that stops at record-keeping. Scheduling in one system, staffing in another, inventory on a clipboard, revenue managed by an outsourced biller working weeks behind the OR. Each tool does its narrow job. Nothing coordinates the whole.
So the coordination happens manually, or it doesn’t happen: operating rooms industry-wide sit at 60–65% utilization, revenue leaks through documentation and coding gaps, and staffing is planned against a schedule everyone knows will change. These aren’t failures of effort. They’re what happens when a tightly coupled operation is managed through disconnected tools.
Hospitals started closing this gap years ago with OR optimization platforms. Those tools never truly reached ASCs — too costly, too heavy, and built on hospital assumptions. The most important site of surgical care ended up the least served by operational intelligence.
What we believe
01The ASC is the future of surgery.
Payers want it, patients prefer it, and clinical innovation keeps expanding what’s safe outside the hospital. More than half of eligible procedures already happen in ambulatory settings, and policy is accelerating the shift. The question isn’t whether surgery moves to ASCs — it’s whether ASCs are operationally ready for it.
02Recording is not optimizing.
Legacy ASC platforms are essential systems of record — scheduling, documentation, billing. But they tell you what happened, not what should happen next. The judgment calls that determine margin still happen in spreadsheets, hallway conversations, and an administrator’s memory.
03Hospital software scaled down is not the answer.
OR optimization tools built for hospitals assume analysts, IT departments, and hospital economics. ASCs run faster turnover, leaner teams, and tighter cost structures — usually with no back office at all. They need software built for that reality from the first line of code.
04Intelligence should sit above the record, not replace it.
Ripping out a working system of record is a multi-year detour. The faster path is a layer that reads the operational signals your systems already produce and turns them into decisions — recommendations a human reviews, accepts, or overrules.
05The operators should build it with us.
The most credible ASC platform won’t be designed in a conference room. It will be shaped case by case with the administrators and physician-owners who live the schedule. That’s why our first customers are design partners, not logos.
Where we are
Perivanta is early. We’re assembling a small group of founding centers to shape the platform against real schedules, real staffing constraints, and real payer behavior.
The industry math, design principles, and product roadmap are on this site so operators can decide whether the design partner program is worth their time.
Design partner program
Help build the system that decides what should happen next
We are selecting a small group of founding centers to shape the platform. Design partners get early access, direct input on the roadmap, and founding-partner terms.