Pathways Perioperative · Live
The pre-operative assessment platform.
From booking to theatre door: Pathways takes the history, profiles the risk, routes the patient, and keeps the record. Built with anaesthetists, for the realities of surgical lists.
Pathways Perioperative is a pre-operative assessment platform for Australian healthcare. A voice agent takes a structured 12-domain anaesthetic history by secure SMS link, patients photograph their medications for verified extraction, a deterministic risk engine screens each case against perioperative guidelines, and every patient is routed to review, clinic, phone call, or straight to theatre.
Platform capabilities
Socrates Pre-Op · the voice agent
A structured anaesthetic interview, taken by voice.
A purpose-built anaesthetic variant — not a generic intake bot. Delivered by secure, time-limited SMS link: no app, no login, no paper questionnaire.
- Every session produces structured, severity-tagged findings that feed the risk engine directly
- Completion is tracked; a finished interview automatically triggers a fresh risk analysis
| Surgical context | Procedure, urgency, planned anaesthetic technique and surgery date |
|---|---|
| Presenting symptoms | Current symptoms relevant to the procedure and to anaesthesia |
| Prior anaesthetics | Previous anaesthetics and complications, including family history |
| Systems review | Cardiac, respiratory, renal, hepatic, endocrine and neurological review |
| Functional capacity & frailty | Exercise tolerance in METs, mobility, and frailty indicators |
| Airway assessment | Airway history, dentition and prior difficult intubation |
| Medications & allergies | Full medication list with photographed verification, plus allergies |
| Social & risk factors | Smoking, alcohol, substance use, BMI and occupational factors |
| Implanted devices | Pacemakers, defibrillators, stents, prostheses and infusion devices |
| Pre-op investigations | Existing results, and which investigations are still outstanding |
| Red-flag screen | Unstable cardiac symptoms and other findings requiring urgent review |
| Safety & shared decisions | Consent context, discharge support and shared decision-making |
Medication & document capture
The medication history stops depending on memory.
During the interview, patients photograph medication boxes, scripts, or prior results from their phone. Pathways reads each image — handwriting included — classifies it, and extracts structured findings.
- Every extracted value is verified against the source image before it enters the record
- Checked against the patient’s recent history for conflicts
- Anything uncertain is flagged for human review — extraction confidence is shown, never hidden
The risk profiling engine
Deterministic, guideline-referenced screening on every patient.
Screening across the domains that drive perioperative outcomes: unstable cardiac symptoms, marked hypertension, diabetes control and SGLT2 management, OSA, frailty, malnutrition, functional capacity, smoking, discharge support.
- Versioned guideline library — the engine cites its references and version on every output
- Pathways tells you what it doesn’t know: missing investigations and unconfirmed timings are listed on every profile
- Contraindication flags: the proposed anaesthetic plan cross-checked against labs, history and interview — critical / warning / info
The rules that protect patients are versioned, testable, and fire every time their conditions are met. They are not model output. They cannot be talked out of it.
| Severity tier | Critical, warning or info — driving the triage recommendation |
|---|---|
| Clinical rationale | Why this finding matters for this patient's procedure |
| Triggering evidence | The interview answer, photograph or result that fired the rule |
| Guideline reference | The published guidance the rule implements |
| Rule version | The exact version of the rule, so the output is reproducible |
| Recommended action | What the service should do next |
Pre-admission tracking & routing
Your clinic sees the patients who need it. Your anaesthetists see the patients who need them.
Every completed profile carries a triage recommendation — anaesthetist review, pre-admission clinic, telephone review, or no further assessment. Everyone else proceeds.
- Team dashboard: sent / opened / completed / expired for every patient
- Automated reminders; link resend in one click
Audit & governance
Built for the perioperative committee, not just the ward.
Org-wide and per-patient audit logs: every analysis, every flag, every user action, timestamped. Full workflow tracing on every risk review — inputs, rule versions, outputs.
- Evidence for M&M reviews and accreditation
- Deterministic rules mean reproducible answers, months later
Safety positioning
Pathways recommends. The anaesthetist decides.
Pathways Perioperative is clinical decision support: clinician-in-the-loop by design, no automated orders, every recommendation reviewable and auditable. It is intended for use by qualified clinicians within Australian clinical governance frameworks.
FAQ
Perioperative platform questions
What is Socrates Pre-Op?
Socrates Pre-Op is the Pathways voice agent that takes a structured anaesthetic history from a patient by phone. It is delivered as a secure, time-limited SMS link — no app, no login, no paper questionnaire — and covers 12 clinical domains conversationally, producing structured, severity-tagged findings that feed the risk engine directly.
It is a purpose-built anaesthetic variant rather than a generic intake bot. The distinction matters in practice: a general-purpose intake tool collects answers to the questions it was given, whereas an anaesthetic interview needs to follow up on a positive family history of anaesthetic problems, probe functional capacity when a patient says they are “fine”, and recognise when a described medication is worth photographing.
Completion is tracked, and a finished interview automatically triggers a fresh risk analysis.
How this compares with the two methods it usually replaces — paper questionnaires and telephone pre-assessment — including where each of those still wins.
Which clinical domains does the Pathways interview cover?
The Socrates Pre-Op interview covers 12 domains — surgical context, presenting symptoms, prior anaesthetics, systems review, functional capacity and frailty, airway assessment, medications and allergies, social and risk factors, implanted devices, pre-op investigations, a red-flag screen, and safety and shared decisions.
Every domain produces structured, severity-tagged findings rather than free text, which is what allows the risk engine to screen on them directly instead of re-parsing a narrative.
How does Pathways generate its risk flags?
Pathways screens each case with deterministic, versioned rules referenced to perioperative guidelines. Every flag carries a severity tier, the clinical rationale, the triggering evidence, the guideline reference and a recommended action, plus the rule version that produced it. The same inputs always produce the same flags, months later.
Screening covers the domains that drive perioperative outcomes: unstable cardiac symptoms, marked hypertension, diabetes control and SGLT2 management, obstructive sleep apnoea, frailty, malnutrition, functional capacity, smoking and discharge support.
Pathways also states what it does not know. Missing investigations and unconfirmed timings are listed explicitly on every profile, and extraction confidence is shown rather than hidden — a profile that is 86% confident about a patient-reported HbA1c says so.
How long does the assessment take a patient?
Most of a Socrates Pre-Op interview is conversational rather than form-filling, and patients complete it from home in their own time rather than in a clinic slot. It can be paused and resumed, and photographing medications happens during the conversation rather than as separate homework. Duration varies with how complex the patient's history is.
The comparison that matters is not against a stopwatch but against what it replaces: a paper questionnaire that arrives in the post and comes back incomplete, or a phone call at a time that suits the service rather than the patient.
Complexity drives length, which is the correct behaviour — a patient with a long medication list and several prior anaesthetics has more to cover than a healthy patient presenting for a day case, and a structured interview should spend the time where the information is.
What happens when Pathways is uncertain about something?
It says so, on the profile. Extraction confidence is shown rather than hidden, anything uncertain is flagged for human review, and missing investigations and unconfirmed timings are listed explicitly. A profile that has not been told about an outstanding echocardiogram is not presented as a clean profile — the gap is part of the output.
This is deliberate, and it is the property that separates a screening tool from a reassurance tool. A system that presents uncertain extractions with the same visual weight as verified ones is making a clinical judgement it has no standing to make.
So a patient-reported HbA1c appears with its confidence attached and “gap: recent HbA1c” recorded alongside it, rather than being silently promoted to a result. The clinician can then decide whether the gap matters for this patient and this procedure — which is the decision that was always theirs.
See a real pre-admission workflow.
30 minutes. Your list, the way Pathways sees it.