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PERIOME Launches to Build the Clinical Infrastructure for Perioperative Health
Fifty million Americans undergo surgery each year. Almost none receive structured preparation for what it demands of the body. Two practising anesthesiologists are building the infrastructure to change that.
Nashville, TN · August 13, 2026
PERIOME today launched as the perioperative health company, building the clinical infrastructure for perioperative health: the system that prepares a patient's physiology before surgery, quantifies readiness before induction, and follows recovery through the full window that follows.
The company was founded on an observation its founders have made thousands of times from the head of the operating table. Surgery has been optimized in nearly every dimension. The procedure has been refined over decades. So has the anesthetic. The operating room itself is engineered to exacting standards. The patient moving through it has not been.
A scheduled patient sees a primary care physician for clearance, a scheduler for a date, pre-admission testing for laboratory work, an anesthesiologist for the minutes before induction, and a surgeon for the procedure itself. Each is accountable for a segment. None of them owns whether the body is ready for it.
The science is decades old. The infrastructure was never built.
Peer-reviewed research has long described what surgical stress demands of human physiology, and what structured preparation can support: metabolic reserve, hydration and electrolyte balance, functional capacity, and immune and cognitive resilience. Enhanced Recovery After Surgery demonstrated at scale that protocolized perioperative care changes the surgical course. But ERAS was built for the hospital and for the day of surgery. It does not reach the weeks before, when the body can still be prepared, or the weeks after, when recovery is still unfolding.
The burden inside that window is well documented. Roughly one in four patients over 65 experience postoperative cognitive dysfunction in the first week after major non-cardiac surgery, and about one in ten at three months. Patients still routinely arrive at the operating room after twelve to sixteen hours without food or fluid. The standard preoperative workup establishes whether a patient is safe to undergo surgery. It was never designed to establish whether they are prepared for it.
In May 2026, the American Society of Anesthesiologists published a consensus article in Anesthesiology, developed with representatives of fourteen professional societies, describing perioperative medicine as a system-level function requiring governance, metrics, and alignment. PERIOME's position is that the field has correctly named the requirement, and that what it now lacks is a substrate: a measure clinicians can agree on, and a record that follows the patient through the whole window rather than stopping at the edge of each specialty.
I have stood at the head of the bed for thousands of cases, and the pattern never changed. We optimize everything in that room except the person on the table. Not because anyone is negligent, but because no specialty owns the weeks on either side of the incision. Perioperative health is the name for that missing ownership, and we are building the system that gives it one.
What PERIOME is building
PERIOME describes perioperative health as a six-layer system. Its clinical entry point is the Perioperative Health Protocol: PREPARE for the seven days before surgery, READY on the day of surgery, and RECOVER for the seven days after, organized around six physiologic domains relevant to the surgical window: hydration and electrolytes, metabolic and recovery capacity, neurocognitive resilience, immune and inflammatory resilience, GI integrity and microbiome, and micronutrient foundation. It is recommended at the pre-anesthesia evaluation and requires no new clinical workflow.
Above it, the company is building the layers that make readiness measurable. The Perioperative Resilience Index will synthesize continuous physiologic data, targeted perioperative laboratory values, and pharmacogenetic profile into a single readiness measure available before induction. Perioperative genomics will personalize that measure to a patient's inherited biology, including how they metabolize the anesthetic and analgesic agents they are about to receive. Recovery intelligence will extend observation through the post-acute window. An outcomes layer will carry what the system learns from one surgical window into the next.
Medicine improves what it measures. We have a number for kidney function, a number for cardiac risk, a scale for how difficult an airway will be, and nothing at all for readiness. Until readiness is measurable, preparing it stays optional. That is the problem worth solving first.
The vision
No one enters surgery unknown. Readiness is measured before induction. Physiology is prepared. Recovery is seen in real time. Every outcome makes the next patient's care smarter. The perioperative window becomes a connected, measurable system instead of a gap between specialties.
The system learns from patterns, not from patients. A person's data serves their own care. What teaches the system is de-identified and aggregate.