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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.
Scorecards are refreshed nightly. Changes from today’s validated cases will appear in tomorrow’s scores. The algorithm intentionally uses peer comparison within procedure cohorts, so scores reflect relative performance, not absolute thresholds.

Four pillars

Each surgeon is scored across four pillars that measure different aspects of operational performance:
PillarWeightWhat it measures
Profitability30%Profit per case compared to peers in the same procedure cohort
Consistency25%Timing variability (coefficient of variation) across case durations per procedure
Schedule Adherence25%How closely actual case durations match scheduled/booked times
Availability20%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)
All pillar scores are floored at 10 and capped at 100.

Grade thresholds

GradeScore rangeDescription
A≥ 80Elite — top performer
B≥ 65Strong — above average
C≥ 50Developing — meeting expectations
D< 50Needs 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.
The minimum case threshold exists to ensure statistical reliability. Scoring a surgeon with only a few cases would produce volatile, unreliable scores that change dramatically with each new case.

FAQ

Because Profitability and Consistency use peer comparison (MAD-based), a surgeon’s score can change when other surgeons in the same procedure cohort have new cases validated. Their position relative to the cohort median shifts even without their own new data.
A surgeon who performs 50 knee replacements and 5 hip replacements gets their score weighted heavily toward knee replacements. This prevents a niche procedure with only a few cases from dominating the composite score.
Pillar weights (30/25/25/20) are currently fixed in the scoring algorithm. Future versions may support facility-level weight customization.
Improvement plans estimate savings by projecting how many minutes/dollars would be saved if the surgeon moved from their current pillar score to the target score, multiplied by their annual case volume.

Next steps

Surgeon analytics

Dive deeper into individual surgeon metrics.

Scoring methodology

Technical deep-dive into the scoring algorithm.