A five-stage reference for what a modern multi-specialty ambulatory surgery center needs in 2026 — covering architectural design, construction, IT implementation, operating room (OR) setup, and the full technology stack of a state-of-the-art ASC.
Architectural, MEP, and IT design happen in parallel. The IT design must be coordinated with the medical equipment planner, the EMR vendor, and the accreditation track from day one.
Demographics, certificate-of-need, zoning, parking, accessibility, ambulance access.
Room counts by specialty: OR, procedure rooms, pre-op, PACU, recovery, sterile processing, offices.
Floor plan, patient flow, staff flow, soiled/clean separation, biohazard pathways.
MEP coordination, medical gas, lighting, finishes, surgical specialty-specific rooms.
Cat 6A, OM4 fiber, Wi-Fi 6E heat-map, IDF/MDF rack elevations, network architecture.
Medical equipment list, room-by-room device counts, OR boom and lighting layout.
HL7 v2.x, FHIR R4, DICOM specs; Epic, Cerner, athenahealth, Provation, HST Pathways.
Administrative, physical, technical safeguards with documented controls.
State DOH, building permits, AAAHC/AAAASF/Joint Commission IT readiness checklist.
IT runs on the critical path. Cabling has to be in the walls before they close. ALIS coordinates the IT track with the general contractor's daily schedule.
Excavation, grading, utilities stub-ins, foundation pour.
Steel or wood framing, exterior envelope, roofing, weather-tight.
Mechanical, electrical, plumbing, medical gas distribution, fire protection.
Cat 6A and fiber pulled and terminated, conduits and J-hooks installed before drywall.
Drywall, doors, hardware, casework, lead-lined rooms for imaging.
OR-rated HVAC with HEPA, positive-pressure ORs, medical gas certification.
Antimicrobial surfaces, integral cove base, sealed flooring, sinks/scrubs.
OR booms, surgical lighting, anesthesia machines, sterilizers, imaging modalities.
Test, adjust, balance; commissioning, life-safety inspections, accreditation mock survey.
The IT track runs in parallel with construction. The order is: cabling → MDF/IDF → network and Wi-Fi → clinical systems → integration → training → go-live.
Cat 6A and OM4 fiber tested, labeled, and certified; patch panels and racks dressed.
Server racks, UPS, switches, firewalls, wireless controllers, structured cabling.
VLAN segmentation, firewall policies, Wi-Fi commissioning vs. predictive heat-map.
Epic, Cerner, athenahealth, Provation, SIS; AIMS (Picis, Epic Anesthesia, Cerner SurgiNet).
Rauland Responder, Hill-Rom Voalte, Ascom; secure mobile (Vocera, Spok, Ascom Myco).
OR AV (Stryker iSuite, Olympus EndoAlpha, KARL STORZ OR1, Getinge Tegris), conference rooms, digital signage, control systems (Crestron, AMX, Extron, Q-SYS).
Cloud PBX (RingCentral, 8x8, MS Teams Phone), SIP trunking, E911 compliance (Kari's Law, RAY BAUM'S Act), VoIP handsets in OR/PACU/front office.
Check-in kiosks, mobile pre-registration, family waiting room displays, tablets.
Door access, IP cameras, intrusion, HITRUST-aligned controls, SIEM/SOAR.
Role-based training: front office, pre-op, OR, anesthesia, PACU, sterile processing.
On-site engineers for first-case days; hourly check-ins; daily issue triage.
Modern ORs are integrated environments. Booms, lighting, imaging, anesthesia, video, and EMR all converge here. Design decisions made in stage 1 determine what is possible in stage 5.
Anesthesia, surgical, imaging, equipment booms (Stryker, Steris, Skytron, Trumpf).
LED with integrated 4K cameras (Maquet PowerLED, Steris Harmony, Stryker).
Stryker iSuite, Olympus EndoAlpha, KARL STORZ OR1, Getinge Tegris.
4K matrix switching, intra-op recording, PACS connectivity, large-format displays.
AIMS workstations, gas monitoring, vital signs, MAC/general anesthesia integration.
C-arm, fluoroscopy, ultrasound, O-arm, navigation (Stryker, Medtronic, Brainlab).
Intuitive da Vinci, Stryker Mako, Medtronic Hugo, CMR Versius, Zimmer ROSA.
Positive-pressure with HEPA, laminar flow over surgical field, scrub-room lighting.
Surgical smoke evacuation, helmets, laser safety, MRI-conditional rooms if applicable.
The bar has moved. AI-enabled clinical documentation, RTLS, robotic surgery readiness, zero-trust cybersecurity, and sustainability are now table stakes for new and renovated ASCs.
Ambient AI scribes, RAG-grounded copilots, anesthesia/op notes/discharge automation.
Network, power, integration for da Vinci, Mako, Hugo, Versius, ROSA.
Real-time location for patients, staff, instruments, mobile equipment (BLE, UWB, Wi-Fi).
Identity-based access, micro-segmentation, HITRUST CSF, OCR audit-ready.
Pre-registration, day-of mobile check-in, family text status, post-op surveys.
Virtual pre-anesthesia, e-consents, post-op video check-ins, EMR integration.
LED lighting, smart HVAC, energy submetering, OR turnover efficiency analytics.
GI, ortho, ophtho, ENT, pain, plastics, urology, cardiology, gyn, spine, podiatry, dental.
AAAHC, AAAASF, Joint Commission, Medicare ASC CoP, HIPAA, HITRUST, state DOH.