Surgery optimized the procedure. It never optimized the patient.
Fifty million Americans have surgery every year. Almost none receive structured physiologic support — before, during, or after. PERIOME turns the perioperative window into a managed clinical journey. The infrastructure medicine never built.
PERIOME begins. Protocol initiated.
Physiologic readiness optimized.
Outcomes tracked. Intelligence built.
Three pillars have been systematically optimized. The fourth has been systematically ignored.
The procedure. The anesthesia plan. The operating room. Each pillar has decades of refinement, dedicated infrastructure, and clinical specialization behind it. But the physiologic condition the patient brings into the operating room — their hydration status, nutritional baseline, mitochondrial reserve, gut integrity, neurocognitive resilience — has never had a discipline, a protocol, or a company responsible for it. Until now.
The protocol is where PERIOME begins. The platform is where it goes.
Five physiologic domains, each targeting a distinct mechanism relevant to surgical stress and recovery — designed as the evidence base of a system that spans the entire perioperative window.
Review the scienceSurgical fasting depletes fluid reserves before the procedure begins. This domain supports electrolyte balance and hydration status across the pre-operative and recovery window.
Surgical stress increases cellular energy demand while fasting limits substrate availability. This domain provides mitochondrial cofactors to support cellular energy production under operative stress.
Anesthesia disrupts neurotransmitter balance and cognitive processing. This domain delivers catecholamine and neurotransmitter precursors relevant to anesthesia emergence and post-operative cognitive function.
Fasting, anesthesia, and antibiotics challenge normal gut function. This domain supports mucosal barrier integrity and GI tolerance through the perioperative period.
Perioperative stress disrupts microbiome stability. This domain provides targeted probiotic strains and activated-form micronutrients to maintain the foundation through surgical stress.
The protocol is the entry point. The intelligence layer is the company. The data is the moat.
The surgical window has never had a system responsible for the patient moving through it. The system has done the administrative work to get the patient to surgery. It has not carried the patient through it. PERIOME PROTOCOL is the first clinical intervention inside a platform being built to own that window entirely. But a protocol is a beginning, not a destination.
Every patient who prepares with PERIOME generates signal. Every outcome — recovery trajectory, symptom profile, discharge timing — informs what comes next. PERIOME is building the learning infrastructure that the perioperative period has never had: a system that connects patient physiology, clinician judgment, and institutional outcomes across the full window from scheduling to recovery — into a continuously improving standard of care.
The physiologic protocol is the foundation. The layers above it connect patient preparation data to clinician decision-making and institutional outcomes — building toward a system that improves the standard of care for every patient who follows.
Grounded in clinical practice. Built for the future of perioperative care.
From inside the operating room
PERIOME was co-founded by board-certified anesthesiologists who identified the perioperative window as the most consistently neglected period in surgical care — and built the protocol to address it.
Every domain has a literature base
PERIOME PROTOCOL targets five physiological systems with peer-reviewed evidence for each ingredient: hydration, mitochondrial energy, cognition, gastrointestinal integrity, and microbiome resilience.
Structured for clinical recommendation
The protocol is designed so clinicians can recommend it with confidence: defined start and end points, one packet per day, aligned with standard perioperative timelines and ERAS principles.
The infrastructure surgical programs have been missing.
Deployment-Ready Architecture
PERIOME integrates into existing surgical scheduling workflows without custom IT buildout. The platform is configured to your program’s procedures, patient population, and outcome priorities.
Outcomes-Oriented by Design
Every deployment is structured around defined metrics: PONV incidence, PACU dwell time, discharge timing, and 30-day recovery trajectory. The data belongs to your institution.
Institution-Owned Data
PERIOME generates a structured, longitudinal perioperative dataset for every enrolled patient — available for quality reporting, research, and value-based care contracting.
Built for Health System Scale
From a single ASC to a multi-site health system, the PERIOME framework scales without degrading clinical fidelity. Each site deployment is standardized, measurable, and reproducible.
“I watched patients arrive at surgery physiologically unprepared for what the procedure demands from the human body. The gap was specific, addressable — and completely ignored by every system designed to protect them.”
Dr. Chad R. Greene is a practicing board-certified anesthesiologist building PERIOME from inside the operating room — where the problem is most visible and the conviction to close it is most earned.
Chad R. Greene, D.O.
Board-Certified Anesthesiologist · Founder & CEO
Prepare. Recover.
Surgery is a moment. The journey is months. PERIOME is the infrastructure for the entire window — built for the patients who face it, the clinicians who guide it, and the systems that carry it.