Operations & Data Strategy · York, PA
Operations run on data. We make it behave.
Reconciliation models, operational dashboards, and reporting automation for high-throughput teams that can’t afford workflow drift.
01 / CHAIN
The Operations Chain
The ends work. The middle breaks.
Enterprise software excels at the bookends—scheduling upfront and billing at completion. The fragile middle is where operational friction hides.
In fast-paced surgical and operational settings, the handoffs in the middle are frequently managed on manual spreadsheets, paper logs, and ad-hoc emails. That is where cases stall, billable charges slip through, and inventory custody becomes opaque. Fixing this isn't an IT overhaul problem—it is a data architecture problem.
02 / WORK
Capabilities & Solutions
Data engineering for teams that cannot stop moving.
Built directly within Excel, Power Query, Power BI, Access, SQL, and VBA — the stack your organization already licenses and trusts.
These patterns were built and refined inside a live surgical environment — not adapted from an off-the-shelf template.
Reconciliation Models
An implant gets used in the OR, but it never shows up on the vendor invoice — or a charge posts with no case record behind it. Built from work reconciling implant and supply charges against vendor sheets and OR logs inside a live surgical environment, these models catch that gap before it reaches a nurse manager, not after.
Operational Dashboards
Block time sits unused for weeks before anyone notices, because the report that would show it takes a data team days to build. These dashboards were built to hand a surgical or rehab manager block-utilization and multi-site case volume straight from source systems, so decisions happen at the point the pattern shows up, not the point someone requests a report.
Reporting Automation
A staff schedule or contact list gets rebuilt by hand every cycle, and the version that goes out depends on who remembered to update it. Power Query and VBA routines built for annual scheduling matrices and standardized vendor-contact workflows replace that manual rebuild with a routine that runs the same way every time and leaves a record of what changed.
Custody & Tracking Databases
A regulated item's custody record lives in a spreadsheet one person can open at a time, with no history of who logged what. Rebuilt from a live tissue-custody system — intake, storage tracking, and chain-of-custody forms — into a relational database with multi-user access, this replaces the single-owner spreadsheet with a shared, auditable record built for regulatory scrutiny.
Data Hygiene & Standardization
The same implant gets entered five different ways across preference cards and logs, so a recall notice never cross-references against usage, and a search for it comes back empty. This work standardized naming and preference-card content across sources so a recall alert or a lookup catches every instance, not just the one spelled correctly.
Maximizing Existing Tools
The fix does not require replacing the EHR, the scheduling system, or the licenses already in place. Every system above — reconciliation, dashboards, automation, and custody databases — was built as a connective layer around Epic, Cerner/Surginet, CPSI, and Medent using tools already licensed, not a multi-year platform migration.
03 / DEMO
Interactive Example
What automated reconciliation delivers.
A miniature before-and-after demonstration using synthetic data. See how normalized keys and reconciliation logic convert invisible operational errors into clear action items.
| Case # | Item Description (As Entered) | Vendor Sheet | OR Log | Charge Posted | Status Detection |
|---|---|---|---|---|---|
| 2481 | ACET SHELL 54MM | ✓ | ✓ | ✓ | ✓ Matched |
| 2482 | acet shell 54 mm — trailing space | ✓ | ✓ | — | Failed Lookup (Trailing Space) |
| 2483 | FEM STEM SZ 11 | — | ✓ | ✓ | Used, Missing on Vendor Sheet |
| 2484 | TIB INSERT 10MM | ✓ | — | ✓ | Charged, No OR Usage Record |
| 2485 | Tibial insert 10 | ✓ | ✓ | dup? | Synonym / Duplicate Entry |
| 2486 | SCREW 6.5 X 40 | ✓ | ✓ | — | Unposted Charge |
// Three separate sheets, three disparate owners, no common key — mismatches caught by chance or lost completely.
| Case # | Normalized Key | Source Match | Validation Result | Assigned Action |
|---|---|---|---|---|
| 2481 | ACET-SHELL-54MM | 3 of 3 | Clean Match | — |
| 2482 | ACET-SHELL-54MM | 2 of 3 | Exception | Post charge to account |
| 2483 | FEM-STEM-11 | 2 of 3 | Exception | Confirm invoice with vendor |
| 2484 | TIB-INSERT-10MM | 2 of 3 | Exception | Audit usage against OR log |
| 2485 | TIB-INSERT-10MM | 3 of 3 | Exception | Resolve duplicate billing record |
| 2486 | SCREW-6.5X40 | 2 of 3 | Exception | Post unbilled charge |
// 6 records evaluated · 1 confirmed clean · 5 exceptions converted into clear, accountable tasks.
04 / PRACTICE
Practice Leadership
Grounded in high-stakes operational reality.
Pivota Systems was founded by Anthony Powers, bringing over twelve years of experience managing high-throughput operational data and surgical supply workflows across regional healthcare systems.
In fast-paced clinical environments, official enterprise software frequently falls short at critical handoffs. Having architected custom reconciliation pipelines, tissue custody databases, and executive reporting systems from within the trenches, Pivota Systems brings that deep domain mastery directly to your team.
As an independent advisory practice, you work directly with the strategist who designs and implements your solutions—ensuring agility, technical precision, and zero bureaucratic bloat.
Technical & Systems Stack
Technical Portfolios & Repositories:
Looking for codebases, query architectures, or deep-dive technical project walkthroughs? Request technical portfolio access →
05 / CONTACT
Tell us where your chain is breaking.
If cases are stalling, billing charges are slipping, or inventory logs never quite reconcile with reality, let's look at the data. No slide decks or sales pressure—just an objective assessment of what is happening.
Prefer direct email? Reach out at anthony@pivotasystems.com