The ORbit Score is a composite metric that measures surgeon operational efficiency. It uses median absolute deviation (MAD) statistics instead of mean-based approaches, providing robust outlier resistance.
Four pillars
Each surgeon is scored across four pillars that measure different aspects of operational performance:
| Pillar | Weight | What it measures |
|---|
| Profitability | 30% | Profit per case compared to peers in the same procedure cohort |
| Consistency | 25% | Timing variability (coefficient of variation) across case durations per procedure |
| Schedule Adherence | 25% | How closely actual case durations match scheduled/booked times |
| Availability | 20% | Prep-to-incision gap and surgeon delay rate |
Scoring methodology
MAD-based scoring (Profitability & Consistency)
These pillars use Median Absolute Deviation instead of standard deviation:
- Median-anchored — the center of the scale is the median of the procedure cohort, not the mean
- 3 MAD bands — it takes 3 MADs from the median to reach the floor (10) or ceiling (100)
- Volume-weighted — scores are calculated within procedure cohorts, then weighted by each surgeon’s case mix
Why 3 MAD bands? With 5–15 surgeons (typical for an ASC), being 2 MADs from the median just means you’re the best or worst — not necessarily an outlier. The wider 3 MAD band provides more useful differentiation.
Graduated decay (Schedule Adherence & Availability)
These pillars use direct graduated scoring with no peer comparison:
Each case receives a score from 0 to 1.0 using linear decay (e.g., a case that starts 10 minutes late scores lower than one starting 5 minutes late). The pillar score is the mean of all case scores, scaled to 0–100.
This approach produces a meaningful absolute score — 77% means “77% on-time effectiveness” without a confusing relative layer on top.
Composite calculation
Composite = (Profitability × 0.30) + (Consistency × 0.25) + (Adherence × 0.25) + (Availability × 0.20)
Grade thresholds
| Grade | Score range | Description |
|---|
| A | ≥ 80 | Elite — top performer |
| B | ≥ 65 | Strong — above average |
| C | ≥ 50 | Developing — meeting expectations |
| D | < 50 | Needs improvement |
Surgeon scorecards
Each surgeon is displayed as a scorecard showing:
- Score ring — animated circular gauge (0–100) with letter grade
- Pillar bars — four horizontal progress bars with raw score and weighted contribution
- Case count and flip-room indicator
- Trend arrow — comparison vs. prior period
- Procedure breakdown — top 5 procedures with case counts
Sort options
Sort surgeons by composite score (default), trend, case volume, or name.
Facility summary
A summary strip at the top shows:
- Facility average composite score
- Total surgeons scored
- Total cases analyzed
- Grade distribution (count of A/B/C/D grades)
Improvement plans
Each surgeon can expand an AI-generated improvement plan showing:
- Summary — current composite → projected composite, with annual time saved and financial value
- Strengths — pillars scoring ≥80 with positive reinforcement
- Recommendations — per-pillar improvement cards with:
- Current score → target score
- Composite impact (points gained)
- Actionable steps
- Projected annual savings (hours and dollars)
Data requirements
Surgeons need a minimum number of cases (default: 15) to receive a score. Below this threshold, an “Insufficient Data” notice is displayed instead of a scorecard.
Next steps
