The Challenge: The “Idle” Depot

As of May 27, 2026…
34,700 patients waiting, unscheduled.

Care is not progressing. Equitable access to care is not assured. The value of Kaiser Permanente is not being realized.

50%+ of surgical queue, unscheduled.

More than half of waiting patients do not know when their surgery will occur. E-mailing, calling, wondering, worrying.

30+ business days, just for a date.

Average wait time just to get a procedure date assigned.

Initial Scheduling Process — Avg Business Days

Last 3 months, as of May 2026
North Valley
54.4
Diablo
46.0
Santa Rosa
41.1
San Rafael
38.9
Central Valley
37.5
South San Francisco
34.6
Napa Solano
34.4
Santa Clara
32.1
GSAA
29.1
San Francisco
26.7
San Jose
23.8
East Bay
21.2
Fresno
15.6
Redwood City
15.4
Other
14.9
South Sacramento
14.8
< 15 days15–30 days> 30 days
Permanente Medicine®
The Permanente Medical Group

The Solution: Enable a Living Depot

Support our 250 schedulers and surgical coordinators by empowering patients to get out of the depot, get on the schedule and get ready.An autonomous solution communicates key scheduling information, connects them with schedulers, and prepares patients — with scheduler support.
1

Prioritize

Ranks queue according to wait, urgency, and readiness. Helps patients and schedulers focus on the highest-value matches first.

2

Communicate & Schedule

Empower patients through guided self-service, with scheduler support on demand. New openings are pushed to patients as they are released.

3

Prepare

Guide patients through pre-habilitation, chronic condition management and surgical optimization — so they arrive prepared for surgery.

OUTCOMESWhat success looks like
Satisfied Members
Better experience for Kaiser Permanente Northern California.
Capacity Without Hiring
Free up our 250 schedulers to handle more volume.
~$22.1M Annual Savings
Reduced scheduler effort, fewer cancellations, lower cost-to-serve.
Plus More
Faster time-to-procedure, fewer “stuck patients”, improved patient outcomes.
Permanente Medicine®
The Permanente Medical Group
Kaiser Permanente · Depot Management

From case request to scheduling — without leaving Epic.

An entire depot of patients who never get lost. The moment a surgeon places a referral in Epic, every patient is held, prioritized, and personally guided to a surgery date — and if anyone waits too long, Kaiser reaches out before they ever feel forgotten. Scroll to follow one patient's journey; the workspace on the right responds as you go.

Scroll to follow Sarah's journey
00Meet Sarah · Orthopedics

It starts the moment her surgeon says yes.

Sarah G., a lifelong Kaiser Permanente member, has never had surgery before. She just agreed to have a total knee replacement. With the Living Depot, Kaiser Permanente can ensure that she's never left wondering what comes next… and no patients slip through the cracks.

01Step 01

It begins in Epic, where her surgeon already works.

How does this happen? Dr. Chen creates a case in Health Connect — no new tool, no extra step in her day. The moment this order is signed, Sarah's care plan is already in motion.

02Step 02

It arrives instantly, through integration.

Existing integration carries the referral straight into the Living Depot — no new Health Connect workflow, no Power BI dashboard, no re-keying. From case request into a prioritized spot in the Living Depot in under a minute.

03Step 03

Sarah joins a depot where no one falls through.

The Living Depot ranks every waiting patient by need — clinical urgency, how long they've waited, are they ready, were they impacted by a strike… we know the elements. Sarah rises to the top. The Living Depot is ready to guide Sarah on her journey.

04Step 04 · Day 1

Her care team gets the first opportunity.

For three days, Sarah belongs to the scheduling team. They call and try to connect, answer her questions, and book her themselves — because a real person on the line is the best first touch a patient can have.

05Step 05 · Day 3

If the days pass, no one waits in silence.

Three days go by — the team is swamped, or the calls went unanswered, and Sarah is still waiting. Rather than slipping through the cracks, the Living Depot automatically reaches out with a personal message from Kaiser Permanente. No one had to remember; the Living Depot simply makes sure she isn't forgotten.

06Step 06

A message arrives — and leads with an offer, not a form.

No app to download, no password to reset. A verified message from Kaiser Permanente arrives as a text — the same place Sarah hears from family. No questionnaires to complete, no barriers, no friction; just a friendly offer to set up the call that gets her scheduled.

Sarah · Yes, find me a time
07Step 07

She picks a time — before any paperwork.

Live openings on the scheduler's Health Connect calendar appear right in her texts. Sarah taps Thursday at 1:00 — a 20-minute call, no waiting room, no callback to chase. Ease of getting care; let's make scheduling simple for Sarah.

Sarah · Thu, May 29 · 1:00 PM
08Step 08

Booked — and written straight into Health Connect.

In two taps her meeting with the surgery scheduler is confirmed. It's integrated into Epic — scheduling can be managed like any other clinic. Nothing is re-keyed; less time wasted for Sarah, less time wasted for the schedulers.

09Step 09

First, her say in who and when.

Now that her call is booked, the Living Depot gathers her preferences so the scheduling visit is a success — starting with whether she wants her surgeon's open block times in hand before they talk.

Sarah · Wants Dr. Chen's block times
10Step 10

Flexibility — only if she wants it.

If Dr. Chen's schedule is full, Sarah can opt for an alternate Permanente surgeon — never forced, always her choice. A sooner date if she wants one, provided to her scheduler for their appointment.

Sarah · Open to alternates within 25 miles
11Step 11

One calendar every scheduler shares.

Everything is integrated into Health Connect. Sarah's preferences appear right on the schedulers' calendar — no added work.

12Step 12

A scheduler takes it from there.

On the scheduling call, Sarah gets a date for her knee replacement — pre-op visits, POM appointment, post-op visits, and ERAS materials are set. The Living Depot knows the surgery is scheduled.

13Step 13 · Surgical readiness

Not simply waiting — preparing.

With surgery on the calendar, the Living Depot assesses Sarah's readiness. Not randomly, but using Kaiser Permanente's Surgical Patient Optimization toolkit. Three things stand between her and a smooth operation — her blood pressure, her blood sugar, and tobacco. Each one becomes a gentle, specific conversation.

Sarah G. · Blood pressure · Diabetes · Tobacco — all flagged
14Step 14 · Blood pressure

Blood pressure, addressed with care.

Not a frightening letter — a plain-language check-in. The Living Depot names the exact reading, explains why it matters for surgery, and asks what's getting in the way.

15Step 15 · Blood pressure

A refill, handled from the couch.

Sarah's been running out of her pills. In two taps, the Living Depot reorders both from her Kaiser Permanente pharmacy — no portal, no pharmacy queue, no lapse before surgery. Amplifying the benefit from existing Kaiser Permanente technology.

Sarah · Reorder · Lisinopril + Amlodipine
16Step 16 · Blood sugar

Blood sugar, the same gentle approach.

The Living Depot already knows Sarah has a glucometer and when her test strips last shipped. It asks about real barriers — and meets her with help, not blame.

17Step 17 · Blood sugar

A follow-up, booked into Health Connect.

Rather than leave it to chance, the Living Depot schedules a quick follow-up with Dr. Reyes — the last prescriber of her diabetes medications — using Health Connect.

Sarah · Follow-up · Dr. Reyes · Jun 12
18Step 18 · Tobacco

The hardest topic, handled with grace.

The Living Depot confirms what the record shows, without judgment, and frames quitting around the one thing that matters most to her right now: a safe surgery.

19Step 19 · Tobacco

Connected to a program that works.

One tap connects Sarah to Kaiser Permanente's tobacco-cessation program — an e-Visit and a coach, timed around her surgery date. Support, not a pamphlet.

Sarah · Connected · KP cessation e-Visit
20Outcome

Scheduled, supported, and ready — no additional workforce.

From a Health Connect referral, Sarah got a scheduler call, a surgery date, and real help with the three things that could have derailed her care — every step centralized in Health Connect, every nudge driven by her personal data. No portal, no phone tag, no patients lost. Now picture the whole surgical waitlist, cared for in the same way.

Concept mockup · Kaiser PermanenteA vision for member-first surgical scheduling.
scheduler.kp.org/depot-management

Depot Management

Search MRN, patient, surgeon…
5In depot
0Awaiting outreach
0Outreach active
1Scheduled
PriorityPatientSurgeonCaseCare windowStatus
High
MW
Marcus W.
MRN-49083 · 68y
PP
Dr. Priya Patel
THA — Right hip
Day 1 of 3Awaiting scheduler
Medium
AD
Arlene D.
MRN-50112 · 53y
MR
Dr. Marcus Reed
ACL reconstruction
Day 2 of 3Awaiting scheduler
Medium
JR
James R.
MRN-50447 · 76y
EC
Dr. Emily Chen
TKA — Right knee
Day 0 of 3Awaiting scheduler
Low
LH
Linda H.
MRN-50603 · 60y
PP
Dr. Priya Patel
Rotator cuff repair
Day 0 of 3Awaiting scheduler
Medium
DB
Darnell B.
MRN-49776 · 57y
MR
Dr. Marcus Reed
Meniscectomy
Day 1 of 3Awaiting scheduler
High
YK
Yolanda K.
MRN-48902 · 70y
EC
Dr. Emily Chen
THA — Left hip
Consult setConsult booked · Wed, May 28 · 7:00 AM
Low
PT
Paul T.
MRN-50921 · 67y
PP
Dr. Priya Patel
TKA — Bilateral
DeclinedDeclined

Why “Living Depot” Isn’t on Epic’s Roadmap

Epic’s design priorities and revenue model leave a structural gap that KP fills.

1

Built for OR Optimization, Not Equitable Access to Care

Epic optimizes OR throughput, provider utilization, and template fill — not patient prioritization, depot routing, or equitable access across care settings.

2

Focused on Reimbursable Events

Epic's revenue model is anchored to billable encounters inside the EHR. Coordination workflows that don't generate a CPT code aren't prioritized on the roadmap.

3

Activity Outside the EHR Is Invisible

Patient messaging, care coordination, depot management, and post-acute touchpoints happen outside Epic — and what Epic can't see, it doesn't incorporate into scheduling tools.

KP operates in the “white space”, Epic doesn’t: equitable access, depot coordination, and out-of-EHR activity.
Permanente Medicine®
The Permanente Medical Group
Living Depot

Patient Self-Scheduling and Perioperative Management Roadmap

PHASE 1
Foundations
Agentic Depot Management
  • Patient availability, cross facility scheduling preference maintenance
  • Wait time intelligence
Book via Scheduler Appointments
Patient Queue Prioritization
Phase 1b
Patient Reserve Date in Block
Phase 1c
PHASE 2
Optimization
Empathy-Driven Optimization
  • SPO Toolkit integration
  • Patient task management
  • Closed loop optimization guidance
  • Monitoring for change in acuity
Pre-Hab Wellness
E-Visits / Patient Reorder
Phase 2b
  • Already-prescribed medications
PHASE 3
Coordination
Arrival Info Call
  • Fasting, arrival info, location and time
Patient Care Plan
i.e. “FedEx” or “Amazon” Delivery Tracker
Cancellation Coordination
  • Cancelled cases & reason validation
Patient CRM
i.e. CareXM, OAS CAHPS, HCAHPS
PHASE 4
Scale for Market
Scalable Deployable Model
  • Integrated risk and complexity assessments (CAST / TimEHR)
Scalable Deployable Model
  • Integrated Surgical Patient Optimization toolkit
BACKLOG
Patient Self-Scheduling
  • Without scheduler
Alternate Surgeon & Location
  • Patient preference
OUTCOMES & METRICS
Depot scheduling timeline · Scheduled/unscheduled ratio · Backlog size · Cancelation rates · OR Utilization · Scheduler productivity · POM encounter efficiency · Post-POM tests outstanding
Permanente Medicine®
The Permanente Medical Group

The Value Proposition: ~$22.1M per Year

OpportunityMechanismImpactAnnual Value
More Efficient Surgery Schedulers

Living Depot reduces the amount of time schedulers work to connect with patients. Time trials show this is up to 25% of the schedulers workday. Information from the scheduling depot makes the scheduling encounter more efficient. No need to reconnect with patients when no dates become available.

Schedulers increase productivity from 6 completions/day (current average) to 12 completions per day with Living Depot. There are current 237 FTE allocated to surgical scheduling in Northern California. A conservative estimate is that a 30% reduction in surgery scheduling FTE would be possible even with an increase in periop throughput.

71 surgery scheduling FTE × 122K (+50K T&B) per year =

$8.7M per year savings
No Need to Hire Additional Surgical Coordinators

The benefits of the surgical patient optimization pilot were realized by employing surgical coordinators (RNs or PAs) to manage the data in the SPO report, connect with patients and direct their next steps. The Living Depot automates this process and allows expansion to all adult patients. No PA FTE required.

Reduced reliance on RN / PA care coordinators for our high throughput, high backlog specialties (e.g. TJ surgery). This role is approximately 0.2 FTE of an RN or PA at each of our 21 medical centers. Just repurposing the existing resources from this pilot will provide savings.

0.2 FTE SPO coordinator × 21 Medical Centers × ~280K (+100K T&B) per year =

$3.8M per year savings
Cancellation Reductions beyond Ortho Total Joints

Automation of the pre-operative optimization process and expansion beyond Total Joints Patients will reduce late cancellations. Late cancellations are difficult to fill with other patients.

The TJ Surgical Patient Optimization workflows were credited with achieving a 0.8% reduction in 0–3d cancellations. Applying this benefit to all adult scheduled surgery case hours will produce substantial savings in the form of reduced waste.

335K adult scheduled case hours per year × 0.8% late cancellation reduction × $3700/OR hour =

$9.6M per year of reduced waste
Permanente Medicine®
The Permanente Medical Group

… Not Everything That Counts Can Be Measured

Living DepotValue to Kaiser Permanente
Members are not left waiting for someone to call them to schedule their surgery

Patients don't have to send electronic messages to their surgeons, leave voicemails for surgery schedulers, or advocate through outreach to Kaiser Permanente Leaders decrying poor access to surgical care.

There is a shift among patients who are waiting for surgery from “unscheduled” to “scheduled”

Patients waiting for unscheduled surgery are more likely to leave Kaiser Permanente than those waiting for scheduled surgery. Patients with a surgical date are more likely to engage in prehabilitation and optimization activities.

A real system exists to allow for load balancing between surgeons and across medical centers

Patients across Northern California are provided equitable access to timely surgical care regardless of geography.

Prehabilitation and Optimization become real, tangible steps in the pre-operative process.

Increased likelihood of harm-free surgery, shorter post-operative length of stay, improved performance in NSQIP SAR.

Modern coordinated care experience.

CareXM scores will improve. Our patients' most frequent complaints focus on ease of scheduling, ease of getting care, emotional experience, trust and teamwork. Coordinated care through the Living Depot will address each of these issues.

Permanente Medicine®
The Permanente Medical Group