A hospital surgical scheduling office.
Someone calls out most mornings, and three coordinators spend the morning on the phone finding cover.
Epic holds the cases and the coverage tool holds the people. The time goes into the gap between them: finding who can cover, chasing a yes, and making sure every person and every record heard about the change.
- One intake for call-outs and swap requests. A text to a dedicated number, an email or a form all land in one queue with a time stamp, instead of in three coordinators' phones. A small AI model reads the free-text message and fills in who, which shift and why. A coordinator sees every request.
- Eligibility comes from written rules, never from the model. Credentials, specialty, hours worked, rest between shifts and call rotation live in a rules table that a manager owns. For each opening, the system lists the people who pass every rule, in the order the department sets.
- The chase runs itself. Eligible staff get a coverage text in that order. The first yes stops the outreach, and the proposed change goes to a coordinator to approve with one tap. Nobody is assigned without that approval.
- A day-of board joins the two schedules. It reads the day's room schedule from Epic through whatever export or interface the hospital's IT team approves, and reads assignments from the coverage tool. It shows each room's anesthesia coverage, open gaps and anyone booked twice, and it refreshes every few minutes.
- Once a change is approved, the people affected get a text, and the change is logged with who approved it and when. Each night a check compares Epic, the coverage tool and the spreadsheet, and lists every place they disagree.
Look at what is already paid for first. Epic OpTime runs the operating room schedule. Coverage tools like QGenda and Amion already handle call rotations, and some include shift-swap and open-shift features that sit switched off. Before building anything, check whether your current tool can take call-out requests and text eligible staff on its own, and what your contract includes.
Custom earns its place only in the glue: the day-of board that joins the room schedule to coverage, and the response chase if your tool cannot do it. Writing changes back into Epic is a decision for the hospital's IT team, so the first version reads only and leaves the system of record to the coordinators.
Clinical judgment stays with people. Whether someone is qualified for a case, and anything a rule cannot capture, is a coordinator's or a manager's call. Privacy and security review belongs to the hospital's compliance and IT teams, and the design should make their audit easy.
The custom layer touches four systems: the room schedule from Epic, the coverage tool, the shared spreadsheet and a texting service. The data is mixed, and every change is approved by a person before it takes effect. That makes a build of $25,500–$36,000. A small AI model reads the free-text requests, so running it is $140–$350/mo, plus $1,500/mo if we operate it. The hospital's security review and interface work run on its own timeline and are not in the band.
- Data access. Epic data usually comes through the hospital's IT team, often as a scheduled report rather than a live feed. Find out what they will approve before designing the board around it.
- Patient information. Coverage needs rooms, times and staff, not patient names. Keep patient details out of the system entirely, which also makes the security review shorter.
- The rules table goes stale. Credentials expire and contract rules change. If nobody owns the table, the list of eligible staff quietly becomes wrong.
- Adoption. If the board lags what is really happening on the floor, coordinators go back to calling around. The board has to be faster than the phone.
A real number takes a real conversation, and that is free. The first step is an hour watching how a morning actually goes, with no patient or employee data involved.