Operating rooms are critical to surgical care and hospital revenue, but inefficiencies in the OR are a challenge at nearly every hospital. Bottlenecks with workflows, scheduling and resource utilization can all hinder productivity.
Health technology company Apella developed an OR optimization platform that uses ambient artificial intelligence, computer vision and analytics to provide organizations with real-time data to grow schedule capacity and improve care quality. The company says its real-time OR monitoring, scheduling and predictive analytics detects, communicates and forecasts OR activity—down to the minute.
Apella uses ambient AI, integrated with electronic health record (EHR) data, to automate and optimize coordination, scheduling and staffing so surgical teams have additional capacity to provide better, safer care to more patients, according to the company.
The company, founded in 2020, raised $80 million in series B equity and venture debt to fuel its expansion to more health systems. The round was led by HighlandX, with returning investors Vensana Capital, Casdin Capital, PFM Health Sciences, Upside Partnership and Operator Partners, and includes new investors K2 HealthVentures, OpAmp Capital and Houston Methodist Hospital.
Apella raised $21 million in a series A round in 2021.
The company currently works with Houston Methodist, Tampa General, the Medical University of South Carolina and other major health systems.
"Ambient AI is transforming healthcare,” said David Schummers, co-founder and CEO of Apella. “We have applied this technology to the most critical part of the health system: the operating room."
Schummers said Apella's customers have expanded beyond the pilot phase, bringing Apella's product suite to enterprise-scale.
"Apella is really focused on helping hospitals unlock unused capacity so they can serve more patients, faster. We are a computer vision-first company. We use computer vision to identify objects and events and predict events into the future to help hospitals run better," Schummers told Fierce Healthcare. The platform also integrates into hospitals' EHR systems.
Using computer vision and machine learning to automatically collect and identify up to 14 surgical case events and autonomously write novel data back to the EHR, Apella ensures healthcare professionals can focus on serving more patients and still go home on time. On average, hospitals that use Apella have experienced a 5% increase in surgical volume, the company claims.
"[The operating room] is the the financial heartbeat of every health system that we've worked with, up to 60% of revenues and 40% of costs, for any health system, sit in the operating room. That does make it the most profitable part of the health system as well. So any optimization or increased capacity to have the ability to treat more patients in the operating room can have a pretty meaningful impact on the bottom line of the health system," Schummers said.
"We're being pulled into other areas as well. The ability to improve capacity and throughput can help in lots of areas. We have spent the last five years demonstrating the outcomes and measuring the results associated with that type of technology in the operating room, and it's pretty meaningful," he noted.
The company plans to use the funding for commercialization efforts and product development. "Hospitals are looking for trusted partners who they can work really closely with them to solve multiple problems, and I think that's what this funding round will allow us to do," Schummers said.
Houston Methodist, which also joined the series B funding round, deployed Apella's technology in more than 200 operating rooms.
“We saw the technology’s impact on our clinical and operation systems during our initial 36-room pilot and have now scaled the technology enterprise-wide,” said Roberta Schwartz, executive vice president and chief innovation officer at Houston Methodist, in a statement.
Houston Methodist's initial OR pilot of the Apella platform coincided with a 10% increase in monthly case volume sitewide, equating to an additional 33 cases per month, Schwartz told Healthcare IT News in February.
"To date, our ambient intelligence project in our operating rooms has seen a 15% increase in OR capacity without adding additional staff members, based on data from an initial pilot in 23 orthopedic and cardiovascular OR rooms," Schwartz told the publication a year ago.
Apella has supported 500,000 surgical cases with its health system partners to date.
"Artificial intelligence comes with a lot of promises, and not all the time does it come with a ton of results," Schummers said. "We've really focused on working with our health system partners to demonstrate the results of these types of technologies so that they can bridge this pilot-to-scale dynamic."
Ambient AI represents a meaningful wave of innovation in hospital operations, he noted. "Ambient is going to be the system of action that sits on top of EHRs for the next 10 years. I think the ones that are going to work are the ones that deliver real value beyond the buzzwords. If you're a health system trying to figure out which one of those is for you, I cannot tell you the value of references. Talk to people who have used the product, ask them what results they're having. Are they seeing measurable ROI, and are their users loving using it and using it every day? If you can have ROI that matters to the buyer and customers and users that use it everyday to make their life easier, I think you have a formula for success in any AI category," he said.
ORs are wildly underutilized, Schummers asserted. In most facilities, OR utilization hovers around 60%, which means between one-quarter and one-third of expensive OR time is going to waste. "That comes from cases that are scheduled for the wrong amount of time. It comes from poor real-time communication and it comes from poor analytics about how to schedule your day the right way. The role of AI is to provide much better data that becomes the source of truth to run the perioperative arena," he said.
The company recently launched Apella Horizon, a capacity optimization solution that brings scheduling, real-time day-of coordination and performance analytics together in a single, connected system. The company’s technology is now being used across procedural areas, including interventional radiology, cardiology and endoscopy.
“The depth at which hospital staff are adopting Apella and incorporating it in their everyday workflows is exciting,” said Corey Mulloy of HighlandX, who has joined Apella’s board of directors. “Health technology—even when it delivers hard ROI—rarely becomes such an integral part of providers’ day-to-day or a problem-solver for health systems.”
"What investors look for is really what health systems look for, which is, have you become an enterprise-wide solution for your customers that allows you to scale? I think we've reached that point where most of our customers have deployed across their whole hospital, if not their whole health system, which really creates the opportunity to scale the product and bring it to more customers," Schummers said. "We're ready to bring this to more health systems, more broadly, and also broaden the product suite to help solve capacity issues more broadly for hospitals."
There are several other companies building AI-driven OR optimizations solutions. Smart hospital platform Artisight offers AI-driven hospital infrastructure and optimization solutions and envisions its technology operating as an "air traffic control" hub for operating room coordination. The company raised $42 million in a series B round in January 2024.
AI-powered operations software provider Qventus developed technology that automates care operations in both OR and inpatient settings. The company picked up a $105 million investment in January.