San Francisco-based Oath Surgical is taking on the fragmented healthcare system with a vertically integrated approach to outpatient surgery.
Launched in 2024, Oath operates three ASCs in Portland, Ore., and partners with more than 175 surgeons and 20 affiliated ASCs nationwide.
“Healthcare costs are rising, and the vast majority of complex care still happens in hospitals — yet at the same time, innovation in the operating room is allowing more and more complex procedures to happen with better outcomes and faster recovery,” Oath founder Oliver Keown, MD, told Becker’s.
At the center of Oath’s model is the vertical integration of software and ASCs. While many existing digital solutions add value, Dr. Keown says they often amount to “putting a plaster on a broken system.” The real opportunity, he said, is building technology into the foundation of care delivery, not layering it on top.
“The real opportunity is to integrate technology at the core and bring data together in a sophisticated way specifically designed for the outpatient surgical setting,” he said. “It’s less about what wasn’t working and more about connecting workflows and unifying data across different modalities — video, audio, clinical, financial, operational — so that we can unlock the power of a truly connected ecosystem.”
That vision is embodied in OathOS, the company’s proprietary multimodal, ambient clinical intelligence system. OathOS uses real-time surgical video and audio analysis to automate workflows and reduce administrative burden across the care continuum, while connecting scheduling, billing, documentation and patient engagement into a single platform. This year, Oath announced a partnership with NVIDIA to further support OathOS with spatial AI infrastructure..
“We saw a huge opportunity to create a model that both leverages AI and technology and gets the business of outpatient surgery directly aligned with surgeons,” Dr. Keown said. “Our core goal is higher quality care at a lower cost.”
Surgeon alignment is the other pillar of Oath’s model. Rather than a traditional management structure, Oath operates on a co-ownership model designed to give surgeons both a financial stake and a clinical voice.
“It’s about engaging surgeons in the technology and workflows, and being a true clinical partner to help build programs that support complex care at higher quality and lower cost,” he said. “Alignment crosses a few vectors — economic, quality, efficiency — so that we can give surgeons the tools and technology to deliver their very best work, and ensure we’re all moving in the same direction.”
Looking ahead, Dr. Keown sees the continued expansion of minimally invasive procedures into the outpatient setting as a major growth driver, and said demand from surgeons has exceeded expectations since the company’s founding.
“We’re seeing real pull from surgeons who are looking for a better partnership model in the outpatient setting — one that enables them to deliver premium, complex, higher-quality, lower-cost surgery,” he said. “For us, that means more centers, deeper engagement with our surgeon partners, and continuing to expand our technology capabilities.”
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