Workflow Operations Score: 3.65/5.0

Pre-Op Instruction Agent

Workflow Automation & Orchestration | External (Patients) audience

The Problem

Surgeries are cancelled due to patients eating/drinking before procedures (NPO violations) or missing medication holds. Pre-operative instructions are complex (NPO timing varies by procedure and anesthesia type, medication holds are procedure-specific) and patients often forget or misunderstand them. Timely, personalised SMS reminders improve compliance and reduce surgical cancellations.

What the Agent Does

Patient is scheduled for surgery; pre-op instructions generated based on procedure type and anesthesia plan
Agent sends SMS at intervals: 7 days pre-op ("Surgery scheduled; start preparing. Reply YES to receive detailed instructions"), 2 days pre-op ("48 hours before surgery, please stop eating/drinking per your instructions"), 12 hours pre-op ("NPO starting now; no food/drink after [time]"), morning-of (arrival time, location, what to bring)
SMS includes personalised instructions: medication holds (e.g., "Stop aspirin 5 days before surgery"), NPO timing, what to bring (ID, insurance card), parking/check-in info
Patient can reply with questions or concerns; escalates to pre-op coordinator if complex issues
Links to educational materials: "What to expect on surgery day" video, anesthesia preparation guide
Confirms patient receipt and understanding: "Reply YES if you understand the instructions"
Tracks compliance: day-before call confirms NPO/medication hold compliance

Data Requirements

Primary Data Sources: Surgical schedule, procedure type/CPT code, anesthesia plan (general vs. regional, type of anesthesia), patient medications and allergies, procedure-specific pre-op requirements, patient contact info (cell phone, SMS opt-in)
Classification: PHI/PII (patient identifiers, medication info, appointment details)
Quality Metrics: SMS delivery rate >95%, patient compliance (NPO/medication hold) >90%, patient understanding >85%, cancellation due to pre-op violation reduction >80%
Complexity: Medium (templated SMS workflow, personalisation based on procedure/medications, response handling)
Systems: Epic (surgical schedule), automated messaging platform (Twilio, Amazon Connect)

Score Breakdown

Criterion	Weight	Score (1-5)	Weighted
Time Recaptured	15%	4	0.60
Error Reduction	10%	4	0.40
Cost Avoidance	10%	3	0.30
Strategic Leverage	5%	3	0.15
Data Availability	15%	4	0.60
Process Clarity	15%	4	0.60
Ease of Implementation	10%	3	0.30
Fallback Available	10%	3	0.30
Audience (Int/Ext)	10%	3	0.30
Composite	100%		3.65

Why It Scores Well

Operational Impact: Reduces surgical cancellations; improves OR utilization
Patient Experience: Clarifies expectations; reduces anxiety
Workflow Integration: Asynchronous messaging; minimal clinical burden
Scalability: Applies to all scheduled surgeries
Implementation Simplicity: Templated SMS workflow, standard procedures have well-defined instructions

Regulatory Alignment

HIPAA: SMS must be encrypted; patient must opt-in; audit trail required
FDA: Pre-operative instructions are clinical guidance; no autonomy concerns
State Telemedicine Laws: SMS-based instructions generally do not trigger telemedicine licensing
CMS/Joint Commission: Pre-operative education is care standard

Sprint Factory Fit

2 sprints (surgical schedule integration, pre-op instruction templates, SMS workflow, patient interface)

Sprints Required: 2 sprints (surgical schedule integration, pre-op instruction templates, SMS workflow, patient interface)
Timeline: 3 to 4 weeks from requirements to pilot
Governance: Anesthesia director and pre-op coordinator approval of instruction templates; audit compliance rates weekly
Success Metrics: SMS delivery >95%; patient compliance (NPO/meds) >90%; cancellation reduction >80%; patient satisfaction >4.1/5

Comparable Implementations

Twilio: SMS for healthcare
Epic surgical scheduling modules
Health system pre-operative education programs

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Governance Risks to Consider

Before deploying this use case, review these agentic AI risks from the Corvair Risk Catalogue. Each is scored on the DAMAGE framework and mapped to regulatory expectations.

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