One Year Later: Owensboro Health Sees Sustained Financial Growth with AI in the OR

At HIMSS last week, during an Optum-sponsored discussion on how health systems are using AI to improve operations, Russ Ranallo, EVP and CFO of Owensboro Health, shared an update on the health system’s use of AI in surgical services after a full year in production.

Owensboro Health, a three-hospital health system in western Kentucky serving more than 400 providers, initially deployed AssistIQ in the operating room with two realities in mind: the need to create a better experience for clinical teams and the need to perform in an increasingly difficult financial environment. For a rural health system, those priorities are closely linked. As Runallo explained, recruiting and retaining providers is hard, and reducing unnecessary burden is part of building a place where people want to work and stay.

One year later, the results are becoming clear.

Runallo shared that across more than 13,000 surgical cases, Owensboro Health has achieved 98–99% accuracy in capturing supplies and implants, helping drive a 24% increase in gross revenue and roughly a 12% increase in net revenue tied to surgical supply charging.

The platform has also expanded into procedural areas. In the Cath Lab, where the system has been live for three months, the first 600 cases are showing similar revenue improvements. Just as importantly, the work has shown how much value was being missed when supply capture depended on fragmented systems and manual documentation.

Watch the video

Watch the full HIMSS session below to hear directly from Owensboro Health CFO Russ Runallo about their experience and results.

A common perioperative challenge

Before AssistIQ, Owensboro Health’s perioperative teams documented supplies through manual entry in Epic OpTime. Circulating nurses often had to locate catalog numbers on packages, search for the correct item in Epic, and enter it during the case.

In an operating room environment that must prioritize the patient and the procedure above everything else, supply documentation often happens under time pressure. That reality can lead to incomplete capture, inventory discrepancies, and a revenue integrity team trying to reconstruct cases after the fact.

“When you have charge capture in the OR, you're depending on manual documentation under time pressure and that person in the room, that's not their main job. You know, they're working with the patient, they're working with the provider.”

Addressing that gap between clinical workflow and reliable data was a key goal of the deployment. In 2025, Owensboro Health reported significant improvements, including a 90% reduction in inventory depletion errors and improved workflows for circulating nurses.

Why AssistIQ technology feels different

At HIMSS, Runallo described why this deployment feels different from earlier healthcare technologies.

“So over the 27 years we've seen EHRs, revenue cycle, ERP analytics and while they were critical investments, they're largely ‘systems of record’. They're designed [to help us] look backward more efficiently but they didn't change how the work happened in real time.”

These platforms created important systems of record, but they typically analyze information after the work is done. When the underlying data is incomplete, any analysis built on top of it becomes less reliable.

Runallo said newer AI tools operate differently.

With AssistIQ, supplies and implants are recognized visually as they are opened and used during surgery. The system automatically associates each item with the patient record and charges it in real time.

What better data unlocks downstream

The improved capture has also created operational benefits beyond billing.

Perioperative leaders now have clearer visibility into what supplies are actually used during procedures. “We've also reduced the number of items we had on our preference cards. [There were] so many items that we didn't realize weren't being used. We've reduced those and we no longer have issues with expired inventory.”

Reliable usage data also supports cost variation analysis across physicians and procedures, giving leaders better insight into surgical supply spend.

Owensboro Health leadership has consistently stressed the need to reduce friction for clinical teams and create a better day for staff in the OR, something that has become increasingly important as health systems address workforce strain and burnout.

Why CFOs are paying attention

For Runallo, the financial results reinforce what perioperative teams have been experiencing operationally. Healthcare organizations, particularly rural health systems, are operating under growing financial pressure.

Runallo noted that recent policy changes could reduce Owensboro Health’s annual revenue by roughly $100 million over the coming years. In that kind of environment, improving how work happens inside surgical services is not optional.

One year after deploying AssistIQ, Owensboro Health is seeing the impact where it matters most: more reliable data into product usage during surgical cases, smoother workflows for perioperative teams, and measurable financial performance.