Recently, the healthcare operations platform TeleTracking expanded its hospital operations platform into ambulatory care with the launch of Operations IQ Ambulatory, designed to help health systems manage outpatient referrals across some of their most complex workflows.

The solution is already being deployed at Carilion Clinic, a not-for-profit healthcare organization based in Roanoke, Virginia, to identify bottlenecks and reduce delays that affect timely patient access. 

Healthcare Innovation spoke with Paul Davenport, VP of Carilion Clinic, about the outcomes.

Could you provide some background on your organization?

Our organization is a six-hospital health system in southwest Virginia. We have a number of ambulatory clinics that span up to the border of West Virginia, toward Tennessee, and toward North Carolina. Our primary service area is about the size of Rhode Island. It goes from urban locations, where we have a large hospital-level one trauma center, to rural areas, where we have 25-bed hospitals and critical access hospitals. We're an academic medical center system.

What prompted your organization to implement the hospital operations platform?

We were the world's first integrated healthcare operations center. In 2012, we created an operations center that was a mix of both hospital operations and movement, and also our air and ground services, our helicopters and ambulances, working in a synergistic way in a very complex system.

We understood our system was complex. As we began to use situational awareness and distributed situation awareness theory, and did research with Virginia Tech, we discovered that healthcare is the most complex human-derived system on earth. That's a Peter Drucker quote from 2002 from Harvard Business Review.

In 2026, it hasn't gotten simpler. We began a journey about exploring how we could leverage people, process, and technology together, which is the foundation of the operations center science that we had so much success with since 2012. Our CEO, Steve Arner, is an advocate for technology innovation, use of AI, exploring AI use in small ways, maybe thinking about it in big ways. It continues to push us to think differently because of the complexity in our system. We know that we have to reduce that complexity for our patients and not translate it to them. That really began a continued search to use technology to reduce the friction that healthcare has within it.

Could you speak briefly about outpatient challenges?

We have a rather large ambulatory network, or outpatient network, that both the hospitals interact with as a system, and our patients interact with independently of our hospitals. The complexity of those can be very challenging because of the number of sites we have. Systems can operate differently; clinics can operate differently; there are different demands within our footprint. In a very urban area, the healthcare needs may be different than in a rural setting, and how to access those.  

It can quickly get very challenging and complex because the number of visits begins to multiply from 1000s and hundreds of 1000s of interactions, perhaps at our hospitals, to millions of interactions that are happening within an ambulatory system. If you think about it, if you've been to a primary care physician and you may need to be referred to a specialist, that referral begins to set a chain reaction of events that need to happen. There may be authorizations; there may be a sequencing that needs to happen of outpatient tests before you actually meet the specialist you're trying to get into.

Could you walk me through how the platform works?

Imagine layering technology over top of that referral network in the ambulatory system. Imagine you could see the capacity of that system. Imagine if you could have the instant visualization and situational awareness of the patient's journey through that ambulatory system.

There could be manual work cues and workflows today that require people to do something, to click on something, to open it up, to progress that somehow manually. We don't have enough people to do that 24/7. The complexity of teaching humans at scale can be challenging, so this tool layers over all of that complexity and begins to be able to program in a way that can be repeatable, that reduces error, reduces friction, and that can be working all the time in the background, so that we can move our people to where they need to be, which is usually closest to the patient.

Could you speak about some of the outcomes you have seen?

Reducing what's called referral turnaround time. It's also being able to visualize things within that system and get recommendations on how to address them. The technology will be able to see when we have a schedule that's mismatched. It is also about not getting the patient out of a sequence.

Something that we learned a long time ago in the hospital operations world is that we use high reliability principles to make sure that we have reduced variability and highly consistent, repeatable outcomes. You want that in healthcare, and the tool helps us drive down that variability, reducing referral turnaround times, opening up access, and being able to see accessibility in the system, mapping patients' preferences to what we provide them.

I've talked a lot about the patient, but the people, the providers who provide this care, are also caught up in the friction I'm describing. It's about alleviating the frustration they may have with unlocking their schedule, out-of-sequence appointments, referrals that take too long, and the visibility of referrals. In some ways, we're using logic from our work in operation center design, and in other ways we're learning to do something from the sky down, not from the ground up.

It's really important to note that time is the most precious thing our patients have, and time is most precious for the healthcare team, so it's really making the most out of that in the most efficient way we can.

Could you talk about employee feedback?

Working in this environment is much different than what we've ever done before. We brought expertise across all disciplines into an intensive session. As we began to unlock the “what is possible,” these folks began to get so excited. These sessions were intense; people were focused; there were no phones up; there was no email going; there was no multitasking. The team was engaged. The type of programming that was occurring was changing in front of your eyes because you were given the feedback in real time.

When you get to people closest to the work, seeing what's possible with technology, and truly beginning to solve problems in a way that we've never been able to before, that's worth it.

Solutions like this have historically taken years. We're in rooms where our feedback is manifesting in real time. It's changing in front of our eyes week to week. You've got to articulate what's occurring, because the people around you can help put the solution together.

What improvements or solutions are you considering right now?

I feel like we're on a magic carpet ride, and I think this is what agile is supposed to be and is probably designed to be. We're learning how to do that. We have a very detailed scope plan and deliverables we're working toward. It is a regimented but focused process we are going through, and it matches what our CEO has told us he expects from us.

What would your advice be for healthcare leaders who are exploring a similar solution?

I don't want to enter a room not knowing how to do something, but these processes and this technology will push you into areas where you're uncomfortable. You really have to trust the process, and trust that you are going to learn the competency as you do it.

The second piece of advice is to articulate what your issues are and what you want to have happen. Do not talk about incremental changes to a system that has friction. Talk about how you want to obliterate the friction for patients and the healthcare teams providing care.

That's the greatest advice I can give: Be okay with being a bit uncomfortable, stay very focused on the problem you're trying to solve, and build your system from the sky down.

Make sure this is about people, process, and technology, and that as the technology transforms our whole system, it does so within the processes within it. We want to move our people where they need to be, and we believe our people need to be closest to our patients. That is the purpose of what we are doing.

Our North Star continues to move in the way our patients need us to, and to design a way that our healthcare teams can provide the care they need to deliver, without creating burdensome processes or technology that could interfere with that.