01 · Who we are

Procedure time, captured. Case cost, structured. Surgical intelligence, delivered.

Hive is data infrastructure for operating rooms on the thinnest margins: rural and community hospitals, surgeon-owned surgical centers, and the programs that train their teams.

Start a conversation How it works

SAMPLE CASE · ILLUSTRATIVE DATAVENTRAL HERNIA · TAPP · OR 2

PHASE

03 / 07

Peritoneal flap

ELAPSED

00:29:00

STEPS LOGGED

ROLES IN ROOM

Workflow capture · confirmed by reviewer · de-identified

02 · Why we do it

The operating room is a data gold mine, waiting to be harvested.

Every case runs on time, people and supplies. Most rooms record when it started and when it ended. Everything in between goes unmeasured, while margins shrink and rural patients travel farther for surgery.

UNMEASURED

$37

a minute of OR time, not counting implants or billable supplies. Few rooms can say which phase ran long.

Childers and Maggard-Gibbons, JAMA Surgery 2018, 302 California hospitals, 2014 dollars

COST RISING

$1,000+

per case in supplies pulled for the case and never used, on margins that are already thin.

Perez et al, JAMA Surgery 2025, mean $1,294 per case across urology, surgical oncology and colorectal

ACCESS SHRINKING

300+

rural hospitals have stopped offering general surgery. Rural patients now travel over an hour for 44% of surgical admissions.

Chartis, Feb 2026 · Mullens et al, JAMA 2025

ROUTINE TURNS URGENT

2.9×

the complications when surgery for acute cholecystitis was delayed rather than done early, from 11.8% to 34.4%.

Gutt et al, Ann Surg 2013, n=618

ELECTIVE TO EMERGENT

The same operation gets more expensive twice over.

Once when it becomes an emergency, and again when it becomes a transfer. Delay is what moves it.

Two separate studies, shown side by side. Bars are indicative, not additive.

ELECTIVE

Baseline

Scheduled, local, routine. The cost of the operation done on time.

EMERGENT

+53%

$7,814 more for an emergency colectomy than the same operation elective.

Haider et al, Ann Surg 2015, NIS 2001 to 2010, colon resection for neoplasm

TRANSFERRED

+$3,490

more per emergency general surgery patient when transferred. Rural residents had 7.11 times the adjusted odds of transfer.

Sakowitz et al, Am Surg 2024, 1.65M patients, 2016 to 2020 · association, not causal

02 · Hub and spoke

A hub is only as strong as its spokes.

Urban hubs are built for complex cases, specialties and high volume. Community and rural hospitals, the spokes, handle elective procedures and treat patients in their own communities, and they are where a region's health shows up first. When a spoke stops doing surgery, surgical access goes with it, and so does that view into population health. The common case travels farther, and when it waits too long it reaches the hub as an emergency.

Spoke doing surgery

Spoke eroding

Hub under load

Illustrative

197

rural hospitals closed or converted since 2005: 109 complete closures and 88 that stopped inpatient care.

UNC Sheps Center closures tracker, 2026 · excludes Rural Emergency Hospital conversions

4.58×

the hazard of transfer for emergency general surgery patients at rural facilities.

Ingraham et al, J Surg Res 2019, NIS 2008 to 2013, 17.2M encounters

51.6%

of Medicare colonoscopies in small-town and rural ZIP codes are done by surgeons, against 6.8% nationally.

Carmichael et al, Surg Endosc 2022, 3.86M procedures, 2017 data

Take the spokes out of a wheel and the hub doesn't get stronger. It wobbles.

03 · How we do it

We measure the case.

One passive capture, confirmed by a person, delivered to a data room the facility controls. Nobody is asked to stop and write anything down.

HARDWARE

Light to install

Cameras placed once, out of the sterile field, record the case while the team runs it the way they always do.

MODEL

Confirmed by a person

Software proposes phases and steps. A person reviews and confirms each one before it counts, so the record is one your team can stand behind.

DASHBOARD

Answers you can act on

Cost per case, block time and variation, in a HIPAA-compliant data room. De-identified by default, and the facility owns its video.

SAMPLE CASE · ILLUSTRATIVE DATAVENTRAL HERNIA · TAPP · OR 2 ·CASE CONFIRMED

PHASEMINVS MEDIAN

Setup

12+2

Access

Peritoneal flap

18+6

Defect closure

7−1

Mesh placement

Flap closure

8+1

Port closure

10−1

CASE TIME

01:08:00

ROOM TIME COST

$2,516

68 min × $37, time only, 2014 dollars

STEPS CONFIRMED

41 / 41

LONGEST VS MEDIAN

Peritoneal flap

+6 min

LIVE TODAYWorkflow and time

NEXTProduct and materials

Hive measures. It doesn't bill, and it doesn't report clinical outcomes.

Built for

Rural and community hospitals

Cost per case here is about keeping surgery open.

Surgeon-owned surgical centers

Every role, every step, observed rather than billed.

Training programs

Every session comes back as data, with no patient in the room.

04 · Roadmap

Data. Intelligence. Infrastructure.

Each stage earns the next.

NOW

Data

The measurement layer. Workflow and procedure time from real training sessions and cases, confirmed by people and delivered to the site.
NEXT

Intelligence

Surgical intelligence, built on measured cases. Product and materials identification. Clinical Performance Indicators™ defined with surgeons, not imposed on them.
HORIZON

Infrastructure

Measured case mix shapes how the next operating rooms are sized and built. Further out, a network of connected ORs could carry remote expertise to the rooms that need it.