At Stanford Health Care’s new Tri-Valley pre-operative clinic, the real work of surgery starts far from the operating room, where patients now cycle through exam rooms, EKG carts and video visits in a bid to end the last‑minute cancellations that have long haunted surgical schedules.
The Pre-Anesthesia and Pre-Operative Evaluation Clinic, or APEC, opened on the Tri-Valley Livermore campus July 13, marking another successful partnership between multiple Technology & Digital Solutions teams. Tania Hrynewycz, Director, SHC Tri-Valley Business and Financial Applications, walks us through the work behind the clinic.
Q: At a high level, what does this project aim to do?
A: This project created an APEC in Livermore that helps patients complete important health screenings and preparation before surgery. Rather than waiting until the day of surgery to identify issues, patients can receive pre-surgical evaluations, testing, scheduling support, and even virtual visit services ahead of time.
The clinic is being designed to streamline the surgical preparation process, improve communication between care teams, and ensure patients are fully ready before their procedure date. The new location will support growing demand in the Tri-Valley region while following many of the successful practices already used at Stanford Health Care's existing APEC clinics in Palo Alto, Redwood City, and Emeryville.
Q: What need or challenge led to the creation of this clinic?
A: The need came from a common challenge in health care: patients sometimes arrive for surgery only to discover that required testing, medical clearances, documentation, or evaluations have not been completed. When that happens, surgeries can be delayed or canceled at the last minute.
For patients, these cancellations can be frustrating, stressful, and disruptive. For surgeons and clinical teams, they can create scheduling challenges and reduce operating room efficiency.
The new APEC clinic addresses this problem by moving more of the preparation process upstream. Patients can complete pre-operative evaluations, EKGs, screenings, and anesthesia reviews before their surgery date. This allows potential issues to be identified earlier, gives clinicians time to address concerns, and reduces the likelihood of same-day surprises.
The project is also expected to reduce unnecessary same-day testing, improve patient throughput, and support approximately 17,000 annual pre-surgical visits across the Tri-Valley and Livermore ambulatory surgery center locations, with anticipated future growth.
Q: Help us understand this initiative’s impact on patients, clinicians, and the organization overall.
A: For patients, the biggest benefit is a smoother and more predictable surgical experience. By completing evaluations and required testing before the operation date, patients are less likely to experience cancellations, delays, repeated visits, or unnecessary stress. This can improve both convenience and overall satisfaction with their care.
For clinicians and surgeons, the project addresses a long-standing request from surgeons for a more efficient pre-operative process. Clinicians will have better access to patient information before surgery, allowing them to identify risks earlier and focus more on patient care rather than administrative follow-up. Better preparation also helps operating room schedules run more smoothly.
For the organization, the clinic improves operational efficiency by reducing non-billable same-day testing, increasing throughput, and creating opportunities for additional revenue through pre-operative workups and referral processes. It also establishes a model that may be replicated at other Stanford Health Care APEC locations in the future.
Ultimately, the project supports the mission by helping patients receive the right care at the right time, while enabling care teams to deliver that care more effectively.
Q: The scope included digital signage, appointment status boards, exam rooms, workstations, an EKG cart, and more. Did that present any challenges?
A: Yes, it is common for a new clinic to have all the TDS equipment in scope. For new clinic openings, it is common for technology, as supported by TDS teams and facility improvements to be implemented together. A clinical program cannot succeed with software alone; it also requires the physical infrastructure, equipment, connectivity, security systems, and clinical workspaces needed to support patient care. In this project, the team coordinated a wide range of components, including:
- Clinical exam rooms
- Workstations and network connectivity
- Telehealth and video visit capabilities
- Appointment management tools
- Clinical documentation tools
- Digital signage and status boards
- Clinical equipment such as EKG carts
- Security systems, cameras, card readers, and duress buttons
- Phone services and referral workflows
The team worked through numerous operational details before go-live, including phone transitions, supplies, security access, lockers, furniture, soap dispensers, hand sanitizers, issue management, and end-user readiness. While these may seem like small items individually, they are all critical to ensuring clinicians can care for patients safely and efficiently on day one.
One unique challenge was that the Tri-Valley clinic is not a direct copy of the existing Palo Alto APEC model. The workflow includes community physicians, a different anesthesia partner, and a new referral and billing process. As a result, the team had to build and validate new workflows while still maintaining consistency with proven APEC practices.
The success of the 1133 E. Stanley APEC Clinic project was made possible through the outstanding partnership and dedication of multiple Technology & Digital Solutions teams working together to prepare the new clinic for patient care.
TDS Facilities played a critical role in coordinating site readiness, infrastructure planning, vendor engagement, and facility preparations needed to support the accelerated go-live timeline. Their efforts helped transform the space into a fully operational clinical environment.
TDS Biomedical Engineering (Biomed) ensured that essential patient care equipment, including clinical devices such as EKG equipment and other medical technologies, were properly deployed, configured, and ready for safe clinical use. Their expertise helped ensure staff had the tools they needed to deliver high-quality care from day one.
TDS Field Services provided hands-on technical support for workstation deployments, hardware installation, end-user devices, connectivity, and go-live readiness activities. Their responsiveness and attention to detail ensured clinicians and staff had reliable technology to support daily operations.
TDS Applications partnered closely with operational and clinical teams to implement and support the software, workflows, scheduling processes, referral pathways, and system configurations required for the new APEC clinic. Their work helped create a seamless experience for patients and staff while supporting efficient pre-operative care.
