Perioperative Education & Outcomes

Better surgery starts before the operating room

Suturly is a perioperative education and outcomes platform. Timely SMS messages guide patients to procedure-specific web content — no app, no login, no PHI over text. Patient-reported outcomes flow back through the same frictionless channel, continuously improving the evidence base for surgical education.

97%
of US adults can receive text messages
98%
SMS open rate vs. 20% for email
0
app downloads, logins, or passwords required
The Problem

Surgical patients are under-prepared and under-followed

Most surgical patients receive a stack of paper handouts they never read, a brief preoperative conversation they can't fully absorb, and minimal structured follow-up after discharge. The consequences are measurable — and preventable.

~50%
of patients cannot recall their surgeon's post-op instructions at discharge
1 in 4
surgical readmissions linked to inadequate discharge education
~40%
of patients report decision regret when insufficiently informed preoperatively
$B+
annual cost of preventable surgical readmissions in the US

What patients get today vs. what they could get

Printed After Visit Summary
Stanford Health Care
After Visit Summary
Date of Visit: 03/15/2026  |  Provider: Dr. Chen, General Surgery
Your Procedure
Laparoscopic Sleeve Gastrectomy
Diet Instructions
Begin clear liquid diet. Advance to full liquids as tolerated. Avoid carbonated beverages. Follow bariatric diet progression as instructed. See attached handout for detailed diet stages.
Activity
Walk as tolerated. No heavy lifting (>10 lbs) for 4-6 weeks. No driving while taking narcotic pain medications.
Medications
Omeprazole 40mg by mouth daily x 30 days
Ondansetron 4mg by mouth every 8 hrs PRN nausea
Hydrocodone-APAP 5-325mg by mouth every 4 hrs PRN pain (Qty: 20, No Refills)
Enoxaparin 40mg SQ daily x 14 days
Resume home medications as directed
Wound Care
Keep incision sites clean and dry. Remove steri-strips after 7-10 days if not already fallen off. May shower after 48 hours. No submerging in water for 2 weeks.
Follow-Up
Schedule appointment 2 weeks post-op. Call (650) 723-XXXX with questions.
⚠ When to Seek Immediate Care
Fever >101.5°F, persistent vomiting, inability to tolerate liquids >24 hrs, worsening abdominal pain, redness/drainage at incision sites, chest pain, shortness of breath, calf pain or swelling.
Printed: 03/15/2026 2:23 PM  |  Page 1 of 3  |  MRN: XXXXXXX
vs.
Suturly Perioperative Protocol
Day −14 · Pre-op
Hi Sarah — your gastric sleeve is in 2 weeks. Your first prep guide is ready: suturly.com/prep/a3kx
Preparing for Your Gastric Sleeve 6 min · Visual guide · English
Day −10 · Diet prep
Your pre-op diet starts in 4 days. Here's your complete guide and daily tracker: suturly.com/diet/m4np
Pre-Op Diet: 14-Day Protocol Interactive checklist · Daily tracker
Day −3 · Medication hold
Reminder: Stop taking ibuprofen and aspirin today. Confirm you've stopped — reply Y or N.
Y
Day −1 · Final prep
Surgery is tomorrow. Final checklist and what to bring: suturly.com/dayof/k8rw
Day-of Surgery Checklist NPO · What to bring · Arrival time
Day +3 · Recovery
Day 3 check-in: How's your pain? Reply 0 (none) to 10 (worst).
6
A 6 is expected at day 3. Tap for recovery guidance: suturly.com/recovery/p2fn
Managing Pain After Surgery Multimodal strategies · When to call
Day +5 · Medication
Did you take your enoxaparin injection today? Reply Y or N.
Y
Week 2 · Outcomes
Quick check-in: How satisfied are you with the information you received before surgery? Reply 1–5.
4

Designed for patients, surgeons, and health systems

For Patients

Timely text messages link to procedure-specific web guides that meet patients where they are — on their phone, in their preferred language, at the right moment in their surgical journey. No app, no login, no barriers.

Pre-op education guides tailored to their exact procedure
Day-of reminders and interactive preparation checklists
Post-op recovery milestones and red flag alerts
Pain management expectations and visual guides

For Surgeons

Structured shared decision-making that scales your best consultation. SMS nudges drive patients to rich web-based education content, while automated PRO capture feeds outcomes data back to your dashboard.

SMS-initiated education linked to rich web-based content
Automated PRO capture (BREAST-Q, PROMIS, VAS)
Outcomes and adherence analytics dashboard
Publication-ready outcomes data for research

For Health Systems

Measurable reductions in no-shows, ED utilization, and readmissions — with built-in quality reporting for CMS, MIPS, and accreditation bodies.

Reduced 30-day readmission and ED return rates
Improved HCAHPS and patient experience scores
MBSAQIP and accreditation compliance support
Epic-integrated workflows for seamless adoption

Grounded in peer-reviewed research, not assumptions

Standardized education improves shared decision-making

A standardized patient education class for breast reconstruction patients improved clinic efficiency, expanded access to care, and enhanced patients' perception of shared decision-making in a prospective single-institution study.

Henn et al. · J Plast Reconstr Aesthet Surg · 2020

SMS-initiated education drives higher completion

Text message prompts that link to web-based content achieve higher completion rates than standalone apps or patient portals, particularly in populations with lower digital literacy.

Systematic reviews across surgical specialties · 2018–2024

Patient-reported outcomes predict long-term satisfaction

Validated instruments like BREAST-Q, captured longitudinally, identify patients at risk for decision regret — but only when captured consistently, which current workflows fail to support.

Cai & Momeni · Aesthetic Plast Surg · 2022

Pain expectations shape post-surgical experience

Post-surgical pain trajectories are predictable using EHR data. Patients who receive structured pain expectations preoperatively report better pain management and lower opioid utilization.

Azad, Curtin, Hernandez-Boussard et al. · J Surg Oncol · 2020

Three steps. No app, no login, no barriers.

1

Enroll

The surgical team enrolls the patient at the point of scheduling. A single click in Epic triggers the Suturly protocol for their specific procedure.

2

Engage

Patients receive timely SMS nudges that link to rich, procedure-specific web content — educational guides, interactive checklists, and outcome surveys. No app download, no login, no PHI in the text itself.

3

Measure

Patient responses flow back to a clinician dashboard. Completion rates, PRO scores, and complication alerts surface in real time.

SMS layer — nudges, reminders, quick responses. PHI-free.
Web layer — educational content, visual guides, interactive checklists. No login required.
Dashboard — completion analytics, PRO scores, complication alerts. Clinician-facing.

Designed for clinical workflows, not just concepts

Suturly is a working system of interconnected tools — a protocol designer for surgeons, a content module library for clinical teams, and a personalized surgical plan for every patient. Each component is built around the operational realities of surgical practice.

Surgical Protocol Designer

Clinician-facing
Gastric Sleeve Breast Reconstruction Blepharoplasty + New Procedure
Preview Publish
Perioperative Stages
Initial Consultation
Pre-Op (2 weeks)
Day-of Surgery
Acute Recovery (0–7d)
Post-Op (1–6 wks)
Long-term Follow-up
Shared Modules
VTE Prevention
Pain Management
Wound Care Basics
Pre-Op Stage — Gastric Sleeve
6 touchpoints · 14 days before surgery · 3 SMS, 3 Web links
Day −14
Welcome & Protocol Overview
SMS → Web guide
SMS Web
Day −10
Pre-Op Diet Instructions
SMS → Interactive checklist
SMS Web
Day −7
What to Expect on Surgery Day
SMS → Visual walkthrough
SMS Web
Day −3
Medication Hold Reminder
SMS only · Confirmation reply
SMS
Day −1
Final Preparation Checklist
SMS → Checklist with NPO reminder
SMS Web

Content Module Library

Clinician-facing
All Modules Education Checklists PRO Instruments
+ Create Module
Education

Understanding Autologous Breast Reconstruction

DIEP, TRAM, and free flap options with visual comparisons and recovery expectations.

Web content 4 min read 3 procedures
Checklist

Pre-Op Bariatric Diet Protocol

2-week liquid diet compliance tracker with daily check-ins and substitution guidance.

Interactive 14-day MBSAQIP
PRO Instrument

BREAST-Q Post-Op Satisfaction

Validated patient-reported outcome measure for breast reconstruction satisfaction at 2, 6, and 12 weeks.

Validated 3 timepoints
Education

VTE Prevention After Surgery

Evidence-based guide to blood clot prevention — when to walk, how to use compression, and warning signs.

Shared module 8 procedures
Checklist

Day-of-Surgery Preparation

NPO confirmation, medication holds, what to bring, arrival time, and transportation plan.

Interactive Shared module
PRO Instrument

Post-Op Pain Trajectory

VAS pain scale captured daily for 7 days, then weekly for 6 weeks. Automated alerts at threshold.

SMS reply Alert-enabled

Personalized Surgical Plan

Patient-facing · No login

Sarah M. — Gastric Sleeve

Dr. Chen · Stanford Medical Center · Surgery: April 8, 2026

Pre-Op · Day −10
Consultation
Completed March 18
Protocol overview
Decision guide reviewed
Pre-Op
In progress · 4 of 6 complete
Welcome & overview
Diet instructions
What to expect guide
Medication review
Final preparation
Day-of checklist
Surgery Day
April 8, 2026
Arrival confirmation
Post-op instructions
Recovery
Starts April 9
Daily pain check-ins
Wound care guide
Diet progression
Follow-up
Weeks 2–12
PRO surveys
Milestone tracking

SMS delivers the nudge. The web delivers the depth.

Short, timely text messages arrive at the right moment — linking to rich web content for deeper learning, and capturing quick outcome responses directly in the thread.

Suturly
PHI-free SMS channel
Hi Sarah — your procedure with Dr. Chen is in 2 weeks. We'll text you everything you need to feel prepared. Your first guide is ready: suturly.com/prep/a3kx
2 weeks before surgery
Today's topic: understanding your reconstruction options and what to expect. Tap to read your personalized guide: suturly.com/guide/r7bm
10 days before
Day 3 check-in: How would you rate your pain right now? Reply with a number from 0 (none) to 10 (worst).
3 days after surgery
6
Thanks. A 6 is within the expected range at day 3. Tap for evidence-based strategies to manage discomfort: suturly.com/recovery/p2fn
3 days after surgery
2-week check-in: How satisfied are you with the information you received before surgery? Reply 1 (not at all) to 5 (very satisfied).
2 weeks after surgery

Evidence-based content designed for comprehension, not compliance

When a patient taps a Suturly link, they land on a procedure-specific guide built for clarity — plain language, visual explanations, structured navigation, and actionable takeaways. No login wall. No app install. Just the information they need, when they need it.

🔒 suturly.com/guide/gastric-sleeve/pre-op
Pre-operative Guide

Preparing for Your Gastric Sleeve Surgery

Everything you need to know before your procedure — what to expect, how to prepare, and how to set yourself up for the best possible recovery.

6 min read
Evidence-based
MBSAQIP aligned
In this guide
Understanding the gastric sleeve procedure
Your pre-operative diet (2-week protocol)
Medications to stop and continue
What to expect on surgery day
Setting up your recovery space
When to call your surgeon

Understanding the Procedure

A sleeve gastrectomy removes approximately 80% of the stomach, creating a smaller, tube-shaped stomach about the size of a banana. This limits the amount of food you can eat at one time and reduces hunger hormones produced by the stomach.

[ Illustrated diagram: stomach before & after sleeve gastrectomy ]

The procedure is performed laparoscopically through 4–5 small incisions. Most patients stay one night in the hospital and return to normal daily activities within 2–3 weeks.

Your Pre-Operative Diet

Starting 14 days before surgery, you'll transition to a high-protein, low-carbohydrate liquid diet. This reduces liver size, which gives your surgeon better access during the procedure and lowers complication risk.

Why this matters: Studies show that patients who complete the pre-op diet have shorter operative times and fewer complications. Your compliance directly impacts your surgical outcome.

When to Call Your Surgeon

Contact your surgical team immediately if you experience fever above 101.5°F, inability to keep down clear liquids for more than 24 hours, increasing abdominal pain not relieved by prescribed medication, or signs of wound infection.

Content is procedure-specific, not generic. Each guide is built for its exact procedure — a gastric sleeve patient sees different content than a breast reconstruction or blepharoplasty patient. Guides are available in English, Spanish, and Mandarin to serve diverse surgical populations.

Authored from guidelines, reviewed by physicians, improved by outcomes

Suturly content isn't generated once and forgotten. Every module follows a structured development process — and every patient's outcome data feeds back into continuous refinement.

01

Clinical Guidelines

Content is authored from society guidelines, institutional protocols, and peer-reviewed literature — MBSAQIP, NAPBC, ACS, and procedure-specific evidence.

02

Physician Review

Every module is reviewed by a surgeon for clinical accuracy, appropriate scope, and alignment with real-world practice patterns before publication.

03

Patient Comprehension

Content is tested for readability, health literacy, and comprehension. Guides are written in plain language and reviewed against health literacy standards.

04

Outcomes-Driven Revision

Patient-reported outcomes, completion rates, and comprehension data feed back into content refinement. Modules that underperform are identified and improved.

The continuous improvement loop: Outcomes data from every patient interaction informs the next version of each content module. This means the platform doesn't just deliver education — it learns which education produces the best surgical outcomes and evolves accordingly.

Architected for privacy from the ground up

PHI-Free SMS

No protected health information is ever transmitted over SMS. Text messages contain only prompts, reminders, and tokenized links — never patient names, diagnoses, or clinical details.

Tokenized Access

Patients access their content through unique, time-limited URLs. No account creation, no login credentials, no passwords to manage or forget. One tap from the text message to their guide.

HIPAA-Ready

The web layer is designed for HIPAA-compliant infrastructure — encrypted data at rest and in transit, access logging, and BAA-compatible hosting on AWS with a three-tier Epic integration roadmap.

IRB-Compatible

Data handling, consent workflows, and audit trails are designed from day one for clinical research contexts — so the platform can serve both clinical care and IRB-approved studies without retrofitting.

Why this architecture — and why it matters
SMS Layer

The delivery rail. Reaches any phone — smartphone or not. No app, no data plan required for receiving messages.

No PHI in message content
Tokenized links only
Simple reply-based PRO capture
Works on all carriers, all devices
Web Layer

The content depth. Rich, procedure-specific education accessible in one tap. No account creation friction means no patient drop-off at login.

No login or account required
Encrypted, HIPAA-ready hosting
Interactive checklists & visual guides
English, Spanish, and Mandarin support
Responsive on any screen size
Data Layer

The outcomes engine. Patient responses, completion metrics, and PRO scores collected and structured for clinical and research use.

Encrypted at rest and in transit
Audit trails for research compliance
Epic integration roadmap (3-tier)
Publication-ready data export

Research infrastructure, not just a product

Suturly is designed to serve as the intervention arm for perioperative education and outcomes research. Define a study protocol, enroll patients, deliver the intervention, and capture validated outcomes — all through the same platform.

Randomized Controlled Trial

Standardized Education & Shared Decision-Making in Breast Reconstruction

Does structured, SMS-initiated perioperative education improve patient-reported shared decision-making and reduce decision regret compared to standard counseling?

Primary outcomeBREAST-Q (SDM domain)
Capture methodSMS at 2, 6, 12 wks
Prospective Cohort

Pain Trajectory Prediction & Preoperative Expectation Setting

Can structured pain expectations delivered pre-operatively modify post-surgical pain trajectories and reduce opioid utilization?

Primary outcomeVAS pain (daily × 7d)
Capture methodSMS reply (0–10)
Outcomes Registry

National PRO Database for Gender-Affirming Surgery

Prospective multi-site collection of patient-reported outcomes across chest, genital, and facial affirmation procedures.

InstrumentsBODY-Q, FACE-Q, custom
ArchitectureMulti-site, scalable
Explore full research capabilities

Built at the intersection of surgery and informatics

Founder

Suturly was founded by Besher Ashouri, an MD candidate at Stanford Medicine with a Master's in Biomedical Informatics. The platform grew out of a straightforward observation: surgeons generate extraordinary knowledge about how to prepare patients and optimize outcomes, but the delivery mechanism for that knowledge — paper handouts, brief conversations, patient portals with single-digit completion rates — hasn't changed in decades. The problem isn't content. It's infrastructure.

Approach

Suturly is built on implementation science frameworks (RE-AIM, CFIR) to design interventions that work in real clinical environments, not just controlled settings. Every architectural decision — from the PHI-free SMS layer to the no-login web content — is grounded in the evidence on what actually drives education completion and reduces disparities in surgical populations.

Entity

Suturly operates under OneHealth Tech Corp, a Delaware C-corp. Infrastructure is designed for HIPAA-compliant production on AWS with a three-tier Epic integration roadmap.

Stanford Medicine
Biomedical Informatics
Implementation Science
Currently Seeking Partners

Let's close the loop between education and outcomes

Suturly is actively seeking clinical and research partners for its initial pilot. Whether you're a surgeon who wants better-prepared patients, a researcher who needs perioperative outcomes infrastructure, or a health system exploring scalable patient education — we'd like to hear from you.

Start a Conversation
[email protected]