CLINICAL SAFETY LAYER FOR AMBULATORY SURGERY

Stop preventable same-day
surgery cancellations.

Keep your PMS, EHR, and pre-op workflow. After clearance, export a CSV — LINCR handles pre-op from there and flags only the patients who need a human.

Book a 15-min pilot call See how it works →
10%
of ASC cases cancel day-of
50–86%
of those cancellations are preventable
$200–360K
recoverable per ASC per year
01 · PROBLEM

10% of ASC cases cancel day-of — most are preventable.

Three causes account for the majority of avoidable cancellations in ambulatory surgery. LINCR closes all three.

30–40%
NPO VIOLATIONS

Patient ate or drank the wrong thing before surgery. Residual gastric content is four to ten times higher in GLP-1 users even after standard fasting.

20–25%
MEDS CONFUSION

Held the wrong drug. Took one they should've held. Anticoagulants and antiplatelets alone drive more than half of med-related day-of cancellations.

10–15%
ARRIVAL / NO-SHOW

Wrong time, wrong location, or the patient never showed. Patient logistics is the single largest coded cancellation category in ASC industry data.

Sources: HST Pathways 2024 State of the Industry, JAMA Surgery 2024, World Journal of Urology 2025.

02 · COST

Each ASC loses $200–360K a year to preventable cancellations.

$1,430
LOSS PER CANCELLATION

$65/min × 22-min idle, the Bass & Gill BMJ Quality Improvement benchmark.

140–260
CANCELLATIONS / ASC / YR

At 10% day-of-surgery rate on 1,400–2,600 annual cases per center.

9.8M
US CANCELLATIONS / YEAR

10% DoS rate across 97.8M US surgical and endoscopic procedures.

Sources: BMJ Quality Improvement (Bass & Gill 2014), HST Pathways 2024, MedPAC 2026.

03 · HOW IT WORKS

Product flow in three steps.

No EHR integration. No retraining. Thirty seconds from export to queued.

  1. 01

    CSV Import

    Office uploads a CSV of cleared, scheduled patients. Or sync nightly via SFTP, HST Data Stream, or a FHIR pull when you're ready.

  2. 02

    Adaptive SMS

    Each patient gets a timed, stateful sequence anchored to surgery time: NPO reminders, per-drug medication review, arrival confirmation. Two-way, branch-aware.

  3. 03

    Exceptions Only

    Dashboard surfaces only patients at risk — NPO violation, held med taken, no ride confirmed. Staff time goes to humans who need humans, not bulk paperwork.

04 · WHAT IT COVERS

A text-based pre-op agent that covers the three preventable causes.

01

NPO Compliance

Timed reminders anchored to surgery time. Confirmations captured. Exceptions escalated. Built-in logic for GLP-1 users with elevated residual gastric content.

02

Med Reconciliation

Per-drug hold/continue logic for anticoagulants, antiplatelets, SGLT2s, GLP-1s, ACEi/ARBs, insulin. Anesthesia protocols built in. Provider approval required before any patient-facing instruction goes out.

03

Arrival Logistics

Address, arrival time, transport, responsible-adult escort — confirmed via two-way SMS the day before and morning of.

05 · ROI

Simple pricing, immediate ROI.

WHAT IT COSTS
$2.5–4.5K/ASC / mo

Annual default, 10% discount. Contribution margin 90–94%. No overage — tier bumps as volume grows.

WHAT IT SAVES
$200–360K/ASC / yr

A 25% cut in preventable cancellations pays for the platform 6–10× over, in year one. [INTERNAL ESTIMATE based on a 4-OR ASC illustrative model.]

06 · WHO IT'S FOR

Built for ASC owners, medical directors, and practice administrators.

One decision-maker. One CSV. One live ASC in two weeks.

SURGEON-OWNERS

You sign the contract and run the schedule. We ship the safety layer inside two weeks and send you the outcome report every 30 days.

MEDICAL DIRECTORS

Every medication hold is a draft requiring your review and approval before patient communication begins. LINCR is decision support, not autonomous action.

PRACTICE ADMINS

Your medical assistant stops chasing 40–60 patients by phone and triages a handful of exceptions. Your existing PMS stays exactly as it is.

07 · FOUNDER

Built by someone who's lived the problem.

Anish Joseph, CAA
Founder & CEO · LINCR

"I'm a practicing Certified Anesthesiologist Assistant. I watched the same preventable day-of cancellations happen every week across the surgery centers I worked in. LINCR is the tool I wanted the night before, not the morning of."

  • Biomedical Engineering, Georgia Tech
  • Practicing CAA — active in ASCs
  • Built the CSV-native MVP end-to-end
08 · FAQ

Questions we get from ASC operators.

Is this HIPAA compliant?
HIPAA does not prohibit SMS. We operate under a signed BAA with Twilio, enforce written patient opt-in before the first message, apply the minimum-necessary PHI standard, maintain an audit trail, and honor STOP at the message level. Pre-op clearance SMS is covered under the TCPA healthcare exemption for treatment-related messages.
Do we need an EHR integration to start?
No. The default onboarding is CSV-in: export your scheduled-cases list after clearance and upload. You can graduate to a nightly SFTP drop, HST Data Stream pull, or FHIR sync later without changing anything patient-facing.
How is this different from HST Patient Engagement, SIS Exchange, Force, or Relatient?
Those are general patient engagement platforms with broad reminder features. LINCR is a clinical safety layer built for ambulatory surgery specifically: a drug-class–aware rules engine, NPO and medication-reconciliation logic, and a real-time intent classifier that detects NPO violations and "I took a held med" signals. The incumbents are partners and distribution channels — not the same product.
How does medication logic work — is an AI giving patients drug advice?
No. The rules engine produces a structured draft hold/continue/modify plan from published guidance (ACC/AHA, FDA, ASA, AAOS). A provider reviews, optionally edits, and approves every plan before any patient-facing instruction is sent. The database records who approved what and when. This is clinical decision support, not autonomous clinical action.
What does pilot onboarding look like?
Two weeks to first live case. Week 1 — BAA signed, CSV template mapped, cadence configured to your case mix, opt-in language reviewed. Week 2 — shadow run on a small cohort, coordinator dashboard training, then live. Outcome report at day 30 and day 90 covering cancellation rate, exception volume, and staff-hour recovery.
What does it cost?
$2,500–$4,500 per ASC per month on the annual plan. Larger multi-facility groups get volume-tiered per-facility pricing. Solo and small-group surgeon practices start at $599 per surgeon per month.

Surgical clearance, on time, by SMS.

Fifteen minutes on the phone. We'll walk through your current cancellation rate, the three-cause breakdown for your ASC, and a single-ASC pilot plan.

Email anish@lincr.io lincr.io