Case Study · Incision

Every operating room,ready beforethe first incision.

Incision is an Amsterdam healthtech company building the digital technology and accredited education that perioperative teams run on: Assist for preparing a surgical case, Academy for accredited surgical learning, and MySPD for sterile processing. Incision has partnered with Levi9 for its technical innovation since 2019, and Nortik engineers work inside Levi9’s external healthcare development team on that platform, expanding it with people who already know the domain.

Accredited courses in Academy: 850+Accredited courses in Academy
SPD error rate reduction at OhioHealth: 40%SPD error rate reduction at OhioHealth
Faster OR turnover at IJsselland: 15%Faster OR turnover at IJsselland

Engagement Overview

Incision makes surgical knowledge something any team can reach rather than something you pick up from whoever happens to be scrubbed in beside you. It started with surgeons and widened to the whole perioperative team, down to the sterile processing staff who never enter the operating room but decide what arrives in it. The stated mission is ten thousand clinics and a hundred million operations a year.

Their CEO, Ritsaart van Montfrans, puts the goal as “aligned and confident OR teams running on processes that are less siloed, less laborious, and less error-prone”. That is an engineering problem as much as a clinical one, and Incision’s technology partner for it is Levi9: off the WordPress stack that was capping the platform and onto AWS, then the back office, the smartphone app the frontline actually uses, and the analytics layer underneath the product decisions.

Nortik is part of that. Our engineers work inside Levi9’s external healthcare development team on Incision, which is the whole shape of this engagement: Incision’s technology partner is Levi9, and Levi9 expanded that team with people who had already built and run healthcare software. The figures on the right are Incision’s own, published for the platform and the hospitals running it, not a measurement of our work.

850+
Accredited courses in Academy: 40%
SPD error rate reduction at OhioHealth: 15%
Faster OR turnover at IJsselland

Engagement: Team extension through Levi9 / AI Consulting
Team: Engineers inside Levi9’s external healthcare team
Focus: Healthcare platform engineering, perioperative domain
Working model: Embedded in Levi9’s delivery for Incision

A sterile processing technician in gown and mask inspecting a surgical instrument through a magnifying loupe at a reprocessing bench

The Challenge

Everything a team needs to know before a case is real, written down, and scattered. Some of it is in the record, some in a preference card, some in a note, and a good deal of it is in the head of whoever has worked with that surgeon longest. When that person moves on, the department loses it. New staff learn the room by standing in it, which is the slowest and most expensive classroom there is.

And the perioperative team is far wider than the people at the table. Nurses, anaesthesia technicians, surgical technologists and sterile processing staff all carry part of the outcome, and for years the education aimed squarely at them barely existed. An instrument reprocessed wrong never reaches the patient as a teaching moment. It reaches them as a delay, a cancelled list, or worse.

Then there is the platform underneath all of it. Incision was growing into new markets with a stack that could not follow: content delivered slowly, and no way to launch a new product without interrupting the service hospitals were already depending on. Surgical video, multiple languages, several products and a regulated healthcare context is not a website problem. That is what took Incision to Levi9 in 2019.

The Solution

Three products, one job: get the knowledge to the person who needs it before they need it. This is the platform Incision has built with Levi9 as its technology partner, and the platform Nortik engineers work on from inside that team.

The Incision Assist materials list open on a tablet held in two hands, showing Mayo stand and back table setup photographs above a categorised instrument list for a laparoscopic appendectomy

Incision Assist: the case, before the case

Assist is what Incision calls the ConfidentOR solution, and its job is to gather, organise and share everything a team needs to prepare for a surgical case. Preference cards, the surgeon's own way of having the room set up, team notes, device and equipment information, custom 3D visualisations of the OR layout, and bite-size education drawn from published material, all in one place a nurse can open on a phone at home or on a tablet in the suite. Setup is guided by OR nurses and technical staff who upload the preference cards and capture what the department already knows, so the knowledge stops living in one person's memory.

Preference Cards
3D OR Setup
Team Notes
Mobile and Web

An Incision Academy 3D render of a patient positioned supine on an operating table with arm boards and support cushions, imaging displayed on the wall behind

Incision Academy: accredited, and filmed where it happens

Academy is the education layer: more than eight hundred and fifty accredited multimedia courses covering procedures, skills, anatomy, technology and the fundamentals of the operating room, filmed in clinical and OR settings rather than staged. Interactive 3D models span more than thirty anatomical regions and were built by anatomists and surgeons together. Around the content sits the part a training lead needs: tailored learning pathways per role, automatic certification tracking, LMS integration, and a supervisor dashboard showing who has completed what. It has been accredited by the Royal College of Surgeons of England as a Surgical Education Centre since 2017.

850+ Courses
Interactive 3D Anatomy
Learning Pathways
RCS England Accredited

The MySPD reporting dashboard on a monitor, showing initial and final assessment bars for assembly, decontamination and sterilisation competency modules coded trainee, independent and mentor

Incision MySPD: competency you can actually evidence

Sterile processing is where an error becomes expensive quietly, and it is the part of the perioperative team with the least education built for it. MySPD answers that with ten standardised competency modules, more than a hundred industry-compliant standard operating procedures reviewed quarterly by a multidisciplinary committee, and thirty-five-plus courses carrying 18.5 CEUs approved by HSPA and CBSPD. Progress is tracked per person against each module, acknowledgements are recorded, and the reporting dashboard turns all of it into an audit-ready view of who is a trainee, who is independent and who can mentor.

10 Competency Modules
100+ SOPs
18.5 CEUs
Audit-Ready Reporting

A perioperative team in scrubs walking a hospital corridor together

Business Impact

The platform is measured where it lands. Incision publishes a forty percent drop in sterile processing error rates across two OhioHealth hospitals in a rollout that reached thirteen sites, worth around half a million dollars a year per facility on their own accounting, and IJsselland Hospital cutting OR turnover times by fifteen percent across every service line. Assist holds a Net Promoter Score of seventy-two, which for software a nurse is handed at the start of a shift is an unusual number. Those are Incision’s figures and their customers’ results, not ours.

What is ours is a share of the engineering behind it. Incision partnered with Levi9 for its technical innovation, and Nortik engineers are part of Levi9’s external healthcare development team on that work: capacity added to an existing team, by people who had already built and run software in healthcare and did not need the domain explained to them. That distinction is the whole point of how we were brought in. In clinical software, an engineer who has to be taught why an audit trail is not a nice-to-have costs more than they add for a long time, and this is a product where the cost of being casually wrong is measured in delayed lists and cancelled operations.

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