Specialty
Cardiothoracic & Vascular Surgery
Bypass and valve surgery are among the procedures Indian hospitals most often bill against a government scheme package rate, and a package pays one price for everything inside it. The oxygenator, the valve, the eleventh unit of blood and the extra day in intensive care are decided in the theatre and in the unit, and counted weeks later by somebody reading a handwritten sheet.
The cost of the case is decided in two rooms and counted in a third.
Theatre and intensive care make every consequential decision. The office that has to defend the claim was in neither.
A cardiac case is a chain: the workup, the consent, the theatre, the pump, the unit, the step down, the discharge summary that releases the claim. Each link is currently held by a different system or by no system at all, and the chain is reassembled by hand at the end, once, under time pressure, by the person least able to check it.
Move past the reconciliation that happens after the patient has gone home. One order carries its own fulfilment, its own charge and its own evidence, so the claim is assembled by the work rather than after it.
Impact and action
Before the incision.
- The workup is a sheaf: an angiogram in one system, a carotid Doppler in another, a dental clearance on paper, an anaesthetic assessment in a register. A case is postponed on the morning because one of them is missing.The pre-operative set is built once as a form with its own validation, filled per case, locked when it is finished, and attached to the order it belongs to.GlyphForge
- The surgical safety checklist is signed on a page that is filed somewhere the quality cell cannot find a year later.The checklist is a form with a formal sign off, versioned, so an old filled copy still matches the design in force on the day.GlyphVigil
Inside the theatre.
- A valve, a graft, an oxygenator and a tray of consumables are recorded on the theatre sheet, and the sheet is the only place they exist until somebody prices it.Each item is issued against the case as it is used, and the bill line and the clinical record are the same object.ForgeVault
The unit.
- The handover into intensive care is spoken, and the receiving team writes what it remembers.The handover runs as a defined procedure with its own steps, and a live board shows every case currently on it and which step each is at.Cadence
- Ventilators and monitors hold hours of data the record never receives, so the note says what a person had time to copy.The devices connect over one managed outbound link, and their output is attached to the patient rather than to the machine.Westron
The claim.
- The discharge summary gates the claim, so a slow summary is a receivable that ages for a reason nobody would defend out loud.Discharge is tracked from start to finish as part of the record, and the financial side moves with it rather than behind it.AtlasVault
One case, one chain.
What the surgical record has to hold.
- The implant, by batch.A valve or a graft is identified on the record and on the bill by the same entry, so a recall notice resolves to patients rather than to a stock ledger.
- The consent, as signed.A consent form with a formal sign off step, locked on completion, holding the version of the wording that was actually put in front of the family.
- The blood.Cross match requests and issues travel as orders, so the unit transfused and the unit recorded are the same unit.