TrenchesAI builds AI tools for perioperative medicine — starting with a conversational chart navigator that learns how clinicians work. Physician-designed. Built for the clinical reality of complex patients and incomplete charts.
Every surgical patient needs a complete preoperative evaluation. The chart contains the information. But finding it, synthesizing it, and flagging what's missing takes 25–30 minutes per case — and that time compounds across thousands of surgeries every month.
Preoperative clinicians navigate multiple Epic tabs, unreliable problem lists, disappearing e-consults, and outside records that don't integrate cleanly — every case, every time.
Abnormal studies with no follow-up. Specialists seen but no perioperative guidance documented. Medications stopped when they shouldn't be. These omissions create risk.
Without a consistent framework, note completeness depends on who's reviewing, how much time they have, and how complex the chart is. Standardization is elusive.
As surgical volume grows, preoperative medicine is the bottleneck. The answer isn't more clinicians — it's giving the clinicians you have better tools.
Peer-reviewed benchmarking studies show AI with retrieval-augmented generation outperforms human clinicians on structured perioperative reasoning tasks. The question is not whether this works — it's whether it's built correctly.
Accuracy on surgical fitness assessment vs. 86% for human anesthesiologists
Ke et al. — npj Digital Medicine, 2025
Time saved per case with AI-assisted preoperative documentation
Ke et al. — npj Digital Medicine, 2025
Projected annual savings per institution from AI-assisted perioperative workflows
Ke et al. — npj Digital Medicine, 2025
When a clinician opens a POM visit, PRISM reads the chart and surfaces a structured draft note — relevant information pulled, gaps flagged, action items surfaced. The clinician reviews, edits, and signs. In Phase 2, the clinician interacts directly with PRISM and the chart in natural language while reviewing the draft — querying, retrieving, verifying. Every interaction is logged, and the system learns over time.
PRISM reads the chart and produces a structured preoperative assessment draft the moment a POM visit opens. Relevant history surfaced, gaps flagged, action items listed. Clinician reviews, edits, signs.
A defined set of clinical standards every note must address. The system flags gaps. The clinician decides. The floor is the same for everyone — the path to it is theirs.
While reviewing the draft, clinicians interact with PRISM in natural language — pulling echoes, cardiology notes, prior anesthesia records, clearance documentation. The navigator emerges from the review workflow.
The same platform follows the patient from POM to the OR to PACU. Every clinician who touches the case uses the same system. Every interaction logged. The system learns and improves over time.
We're working with perioperative medicine programs to validate this approach. If you're a health system, clinical leader, or engineer interested in what we're building, we'd like to hear from you.
contact@trenchesmd.ai