Digital Pre-operative Workflow – from Medical History to Informed Consent
Hospitals today digitalise individual steps. medudoc digitalises the entire pre-operative process – in one seamless workflow, from a single platform, across all specialties.
The pre-operative process is fragmented, paper-based and time-intensive
Requirements for pre-operative patient intake have increased significantly in recent years. Legislators and courts demand individual, complete and documented patient education. Yet the reality in many hospitals looks very different.
Typical problems in everyday clinical practice:
- Handwritten medical history forms – incomplete, illegible, without consistency checks
- Clinicians reviewing unstructured documents and following up on missing information
- Patient education taking place under time pressure – with risks for documentation quality and legal compliance
- Every patient receives the same generic consultation – regardless of their risk profile
- Consent documents are printed, signed by hand and archived manually
- Data is collected multiple times – in the medical history, the consultation and the HIS
Inefficiency
Repetitive consent consultations consume physician time that is needed for core medical tasks.
Legal Uncertainty
Incomplete patient education increases liability risk for institutions and physicians.
System Breaks
Data is captured multiple times and transferred manually – a source of errors and a loss of time.
Seven Steps. One System. No System Breaks.
medudoc maps the complete pre-operative process in one continuous, rule-based workflow – from patient invitation to HIS handover.
Patient Invitation
The hospital invites patients into the digital intake process via email, SMS or QR code. Alternatively, the process starts via a generic QR code in the waiting room. No patient account required, no app installation needed.
Digital Medical History with Medical Reasoning
Patients complete the structured digital medical history on any internet-enabled device – at home, in the waiting room, on a tablet. The platform checks completeness in real time and asks adaptive follow-up questions: if a patient reports a pre-existing condition, the platform automatically asks the clinically relevant additional questions that medical staff would need to clarify anyway.
Automated Pre-assessment & Risk Score
The platform processes medical history data automatically: risk factors are flagged, standardised metrics (e.g. BMI) are calculated, incomplete entries are marked. Results are presented in a structured format in the HCP Dashboard. The final medical decision always remains with the attending physician.
Physician Validation
Physicians see all patient cases in a clear working interface: medical history analysis, risk score, completeness status and configurable alerts. On this basis, they decide whether a telemedicine consultation is sufficient or whether an in-person appointment is required.
Personalised Video-assisted Patient Education
Based on the planned procedure, anaesthesia method, pre-existing conditions and risk profile, a patient-individual education video is automatically assembled. No generic standard videos – patients receive exactly the information relevant to them. Video creation takes just seconds – in up to 23 languages.
Electronic Consent & Consent Trail
The Informed Consent is generated as a patient-individual IC Sheet, electronically signed and archived in an audit-proof manner. The complete education process – which video content was viewed and when, timestamps of consent – is documented as a consent trail. Legally compliant, verifiable, accessible at any time.
HIS Handover via FHIR
Medical history results, consent status and IC Sheet documentation are automatically transmitted back to the Hospital Information System – via standardised FHIR interfaces. No manual export, no duplicate data entry.
Digitalisation of the Pre-anaesthesia Clinic
The area with the greatest leverage for digitalising the pre-operative workflow. medudoc covers all four central anaesthesia categories in full.
General Anaesthesia
Inhalation and intravenous anaesthesia procedures, intubation, laryngeal mask, TIVA
Neuraxial Anaesthesia
Spinal anaesthesia, epidural anaesthesia, combined spinal-epidural anaesthesia
Regional Anaesthesia Upper Extremities
Brachial plexus, ulnar nerve block, wrist block
Regional Anaesthesia Lower Extremities
Femoral nerve block, sciatic nerve block, peripheral nerve blocks
The Strategic Goal: ASA I and ASA II Consent from Home
Patients in anaesthesia risk classes ASA I (healthy) and ASA II (mild systemic disease) make up the majority of all elective procedures. With medudoc, the entire pre-operative consent process for this group can take place fully from home:
- Digital medical history completed at home
- Education video watched at home
- Consent signed electronically
- Physician consultation via telemedicine – where clinically appropriate
The result: Patients avoid a physical outpatient visit. The hospital significantly reduces the burden on its pre-anaesthesia clinic – at equal or higher quality.
reduction in physician consent time for cholecystectomies – from 9.7 to 2.2 minutes
Study University Hospital Würzburg · Thieme 2024 · DOI 10.1055/s-0044-1790093additional consultation per physician per day – already at 1.5 minutes saved per patient
Salzwedel et al. 2008 · Schuster et al. 2004Maximum legal compliance and economic efficiency are not mutually exclusive
The effectiveness of the medudoc workflow is supported by independent studies and practical experience from leading hospitals.
Why Every Patient Needs Different Content
Generic education videos and standard forms are not sufficient. The law requires individual patient education tailored to the specific person and the specific procedure. medudoc implements this technically.
A patient undergoing knee surgery under spinal anaesthesia with hypertension receives different content than a patient with the identical procedure and no pre-existing conditions under general anaesthesia.
What factors into personalisation:
- Type of planned procedure
- Selected anaesthesia method
- Pre-existing conditions and medication
- Allergies and individual risk factors
- Age and further demographic parameters
- Results of the digital medical history
Available Across Many Specialties
medudoc covers the high-volume procedures of the most important specialties. All content is reviewed annually by medical professionals.
Anaesthesiology
General, spinal, epidural and peripheral nerve blocks
General & Visceral Surgery
Cholecystectomy, hernias, colonic procedures, appendectomy
Orthopaedics & Trauma Surgery
Joint surgery, arthroscopy, endoprosthetics, spine
Ophthalmology
Cataract, laser treatments, glaucoma surgery
Gynaecology & Obstetrics
Laparoscopy, hysterectomy, IUD, conisation
Urology
TUR, prostate surgery, brachytherapy
ENT
Tonsillectomy, septoplasty, tympanoplasty
Vascular Surgery
Varicose vein surgery, carotid endarterectomy, endovascular procedures
At the Level of a Maximum Care Hospital
Hospitals process special categories of personal data with medudoc. The platform meets the strictest requirements of German and European data protection and IT security law.
ISO/IEC 27001:2022
Certified since April 2026, valid until March 2029. Fully covers development, operations, maintenance and distribution of the platform.
BSI C5 — Cloud Compliance
BSI C5 Type 1 successfully completed in May 2026. Type 2 in the assessment period until October 2026.
Data in Germany
All patient data is processed exclusively in Germany. AI processing exclusively within the EU. No third-country transfer.
Encryption & Availability
AES-256 for data at rest, TLS 1.2+ for all transmissions. 99.9% availability contractually guaranteed.
HIS Interoperability
FHIR-based interfaces for bidirectional data exchange. Support for HL7 FHIR, SNOMED CT and ICD-10.
Trust Centre
All certificates, data protection documentation and DPA template for data protection officers, IT security and compliance teams.
Frequently Asked Questions about the Digital Pre-operative Workflow
What is a digital pre-operative workflow?
A digital pre-operative workflow digitalises all steps of patient intake prior to a planned procedure: the structured medical history, the automated pre-assessment of risk factors, patient-individual education, and the legally compliant electronic consent with audit-proof documentation.
medudoc maps this entire process within a single system — from the patient invitation to the transfer of data back to the HIS.
What is Medical Reasoning — and is it a medical device?
Medical Reasoning describes the platform’s ability to ask targeted additional questions during the medical history process. If a patient reports blood-thinning medication, the platform automatically asks for the clinically relevant details.
Medical Reasoning does not make medical decisions and does not replace physician judgement. The final medical decision always remains with the treating physician. This does not constitute a use case within the meaning of the EU Medical Device Regulation (MDR).
Can the entire consent process take place from home?
Yes — for patients with a low risk profile, that is the stated goal. ASA I and ASA II patients can complete the medical history at home, watch the education video at home and sign consent electronically.
Whether telemedicine consent is sufficient or an in-person appointment is required is decided by the physician individually for each patient.
How does HIS integration work?
medudoc offers FHIR-based interfaces for bidirectional data exchange with hospital information systems. Patient master data flows from the HIS into the platform; medical history results, consent status and IC Sheet documentation are returned to the HIS upon completion.
In which languages is the platform available?
medudoc provides education content in up to 23 languages. The legally binding consent is obtained in the original language version; translations serve as a comprehension aid (convenience translation).
Is electronic consent legally valid?
Yes. Electronic consent with medudoc meets the requirements of the German Patients’ Rights Act (§§ 630a–630e BGB) as well as the Austrian Patients’ Rights Act. Documentation is archived in an audit-proof manner and contains the complete consent trail.
Where is patient data stored?
All patient data is processed and stored exclusively in Germany. AI-supported processing steps take place exclusively within the European Union. No data transfer to third countries takes place.
Digitalise the Pre-operative Workflow at Your Hospital
Start immediately with a free trial and experience for yourself how the pre-operative process can be fully mapped digitally — from medical history to consent.
- Start for free
- Subscription cancellable at any time
- No hidden costs
- Works without IT integration
- ISO 27001 certified
- BSI C5 in assessment
- Data in Germany
- 23 languages