The Vision
Today, AI tools do what you tell them. Tomorrow, an autonomous system observes your practice, adapts overnight, and surfaces only what your brain needs to decide. Not a dashboard. An organism.
A surgeon's clinical judgment is the DNA of the practice — it can't be replicated. But today, surgeons spend only 30% of their time on surgery and clinical decisions. The rest is information logistics.
An agentic practice flips that ratio. Six autonomous agents handle compliance, revenue, documentation, patient communication, ambient capture, and surgical readiness — while the surgeon focuses on what only a surgeon can do.
70% information logistics
15% high-judgment decisions only
Each agent mirrors a biological system that keeps the organism alive. Together, they form a self-regulating practice.
Immune System
Constantly scanning for threats — missed deadlines, OAT thresholds dropping, CMS penalties approaching. Reacts to danger before the surgeon knows it exists.
Metabolic System
Converts every patient encounter into energy. Auto-selects optimal CPT codes like cells auto-regulate glucose uptake. Nothing billable falls through the cracks.
Protein Synthesis
Takes raw clinical data and assembles it into structured outputs — LMNs, PROM interpretations, care plans. Template + input = output, like a ribosome.
Nervous System
Sends and receives signals — SMS PROMs, appointment reminders, milestone sharing. The interface between the organism and its environment.
Sensory Cortex
Listens to everything — encounters, calls, notes — and converts raw sensory input into structured clinical memory. Always on, always learning.
Reproductive System
Identifies when conservative care has failed and a new episode — surgery — needs to begin. The division and differentiation moment.
The Breakthrough
Every 24 hours, two meta-agents review the entire system, debate what needs to change, and modify tomorrow's behavior. Like the brain during sleep — consolidating memory, pruning noise, strengthening what matters.
Two meta-agents read every patient encounter, PROM score, billing event, and communication from the past 24 hours across all 6 agents.
Condense the day’s activity into actionable insights. Which patients are falling behind? Which revenue was missed? Which care plans need adjustment?
The two agents have a contrarian discussion — one argues the current approach is working, the other pushes for optimization. This adversarial process prevents stagnation.
Based on conclusions from the debate, they modify tomorrow’s agent priorities — reweight token allocation, reprioritize outreach, flag cases for surgeon review.
Forward Pass
One day of autonomous agent operations across all patients
Loss Function
Patient outcomes (PROM scores) vs. predicted trajectory
Backward Pass
Nightly synthesis adjusts tomorrow's agent behavior
Weights
Agent configuration files that determine priorities, thresholds, and actions
The system gets better every day it runs. That's a compounding data moat no competitor can copy.
Patient enters the surgical readiness zone
Surgical Readiness Agent spawns a specialized sub-agent for that patient’s pre-surgical pathway — insurance verification, imaging coordination, consent documentation.
Surgeon hits 100 active patients
System recognizes it needs a dedicated triage layer and auto-creates a Patient Intake Agent that didn’t exist before.
Practice adds a second surgeon
System differentiates practice-level agents from surgeon-level agents — shared compliance infrastructure, individualized patient communication.
Every other platform
What we're building
The Platform
SurgeonAccess isn't just 8 agents for orthopedics. It's the open agent infrastructure for every surgical specialty. Orthopedics is vertical one.
Now → 200 surgeons
8 proprietary agents. $299/month. Prove the model. Build the data moat.
200 → 2,000 surgeons
Open-source the agent framework. Third parties build agents on our platform.
2,000+ surgeons → every specialty
The framework works for ANY surgical specialty. We become the infrastructure layer.
Open Source
Proprietary (10 Patents)
Open the infrastructure everyone builds on. Keep the intelligence that makes it valuable.
110,000+ surgeons across 10 specialties. Same infrastructure. Specialty-specific agents.
Orthopedics first. Then everything.
Boulder Startup Week 2026
How AI is replacing the back office for specialty medicine. A live demo of agentic staffing built by a 3-person team in Boulder using Claude, Next.js, and 60 days of obsessive focus.
Blaine Warkentine, MD MBA
Co-Founder & Board — Boulder, CO
Levonti Ohanisian, MD MBA
CEO & Co-Founder — Stanford Ortho
Start with a free profile. Your first agent is already watching your compliance.