A shared spreadsheet holds values. It does not hold a state. It cannot say that this physician's file has been waiting nine days on one missing document, or that the person who was supposed to act on it went on vacation.
Imed moved a five-thousand-physician operation off shared spreadsheets
A critical care and physician group management company now runs 43 operational workflows on one system. The bottleneck it removed was never clinical.
The layer between the physician and the hospital.
Imed recruits, credentials, schedules, pays and measures physicians inside buildings it does not own. Emergency departments and intensive care units are the core. The bottleneck it removed was never clinical.
Critical care and physician group management
5,000Physicians, by the company's own published figures
43Hospitals, none of them owned by Imed
74Projects across the service lines
30+Years in medical group management
43Workflows liveCounted by Imed across purchasing, quality, innovation, operational support, marketing, finance, commercial and HR.
~300Credentialing files a monthAverage read off Imed's own dashboard during the interview.
~71%Tooling savingsReported after consolidating a CRM platform in. The cost base is not specified.
Week to hoursFinance to credentialingThe interdepartmental request loop that used to run on email.
260Finance demands in 3 monthsAgainst an expectation of 30 to 35 a month. About two and a half times what was assumed.
~30/dayVirtual reassessmentsScheduled from a form that lives inside the hospital's own system.
“What we say is that we basically have 3,500 innovative people inside Imed, because the more the processes are fluid and automated, the more the physician at the front line can give attention to the patient. They don't carry as much bureaucracy.”
Diogo RossiInnovation, Imed
BeforeAfter
- Shared Excel as the system of recordEach request is a record with an owner, a phase and a clock
- Email between finance and credentialingA form that lands on the responsible person, assigned by unit
- Harvesting spreadsheets to build one dashboardIndicators computed from the work itself, live
- Spreadsheet emailed to a director for approvalA link the director approves, which then routes to whoever executes
- A separate CRM platformThe same system, with the platform cost removed
The hospitals' own systems stayed. A Jestor form sits inside the hospital's software, so the physician fills it there and the request arrives on Imed's side ready to be scheduled. The telemedicine platform stayed too: still where the virtual consultation happens, now queued and tracked.
The company is the layer between the physician and the hospital
Imed manages medical groups on behalf of hospitals. Its core is emergency departments and intensive care units, and its product is everything between the individual physician and the institution: recruiting them, credentialing them, scheduling them, paying them, measuring them, and standing behind the quality of what they do inside a building the company does not own.
By its own published figures the company works with roughly 5,000 physicians, across 43 hospitals, on 74 projects, with more than thirty years in medical group management. Its service lines are intensive care, emergency medicine, hospital medicine, cardiology, pediatrics, obstetrics and gynecology, a telemedicine arm, and continuing education for the clinical teams it places.
That shape is the whole operational problem. A hospital that employs its own physicians has one credentialing process, one payroll, one set of shift rosters. A group management company has one of each, per hospital, per physician, forever, and none of the buildings are its own. Every hospital has its own documents, its own approval chain, its own systems and its own idea of what a complete file looks like.
So the company's real product is not clinical. The clinical work is done by physicians who are already good at it. What Imed sells is the ability to put the right qualified physician in the right building on the right night, with every document in order, and to do that a few thousand times a month without anyone noticing the machinery.
“What we say is that we basically have 3,500 innovative people inside Imed, because the more the processes are fluid and automated, the more the physician at the front line can give attention to the patient. They don't carry as much bureaucracy.”
That sentence is the case. Every hour of administration that does not disappear is an hour a physician spends on a form.
The spreadsheet was not the problem. The absence of state was
Before Jestor, the entire management of the medical group ran on Excel.
“All of that management was done through Excel spreadsheets, which was extremely laborious. Information got lost. The spreadsheets were shared, so often one person edited the information and didn't save it, another person lost it at the other end, and so on.”
“Managing the indicators was also very complex, because we had to collect several different spreadsheets to include them in a single dashboard, in a single place. So it was really quite difficult.”
Every indicator had to be assembled by collecting several different spreadsheets and merging them into one place. The reporting was not a byproduct of the work. It was extra work, done after the fact, by hand.
When finance needed banking data for a physician, it sent an email to the credentialing department. Sometimes the answer came back a week later. Nothing was broken and nobody was negligent. There was simply no mechanism that could say a request existed, who owned it, and how long it had been open.
“That process was often done by email and sometimes it took a week for us to get an answer. Today we can sometimes answer the finance department within a few hours.”
Item by item, what did each job before and what does it now
| What did this before | What does it now |
|---|---|
| Shared Excel spreadsheets as the system of record | One system where each request is a record with an owner, a phase and a clock |
| Harvesting several spreadsheets to build one dashboard | Indicators computed from the work itself, live |
| Email between finance and credentialing | A form that lands on the responsible person, assigned automatically by unit |
| Spreadsheet emailed to a director for approval | A link the director approves, which then routes to whoever executes |
| No single way for a hospital to reach finance | One channel, one link, every demand recorded |
| A separate CRM platform | The same system, with the platform cost removed |
| Reassessment appointments arranged case by case | A form inside the hospital's system that creates a scheduling record, tracked on a board |
| Performance feedback tracked informally | A flow with a deadline, a notification to the manager, and the employee informed at conclusion |
What was not replaced: the hospitals' systems. Imed did not ask 43 hospitals to adopt anything. It put its own form inside the hospital's system, so the physician requesting a virtual reassessment stays in the software they already use and the request still lands in Imed's queue. This is the integration that mattered most, because the alternative was asking a client to change how its physicians work.
The chain, from a credentialing request to a physician on shift
- 1A manager opens a requestPerson, anywhere
The form is public, so a hospital manager who does not have a login can still file one.
- 2An owner is assigned automaticallyAutomated
An automation names the responsible professional based on the unit.
- 3Documents are gathered and the file moves through phasesPerson
The row turns green when everything is in order.
- 4Priority is set by the shift dateAutomated
The bottom of the app ranks files by when the physician is actually due to work, not by when the request arrived.
- 5Finance asks for banking data through its own formAutomated
It lands on the same responsible person instead of an inbox.
- 6The file goes to the hospital and the coordinator is notified of progressAutomated
The hospital receives the completed file; the coordinator sees the status without asking.
- 7The dashboard reads the queueAutomated
Volume per month, time parked in each phase, files overdue, files updated in the last ten days, files incomplete at the early stages.
The two hard parts of this chain are the first and the last. The request has to be openable by someone who does not work for you and does not have your software, and the queue has to be readable without anyone assembling a report. Every credentialing operation that runs badly runs badly at exactly those two points.
Every figure, with the basis beside it
| Measure | Result | Where it comes from |
|---|---|---|
| Tooling savings | ~71% | Reported after migrating a CRM platform into the same system. The cost base is not specified in the source, and the figure appears as 72% in the interview and 71% in Jestor's own published summary. See the limits below |
| Workflows live | 43 | Counted by Imed at the time of the interview, across the areas named above |
| People on the platform | 3,500+ | Imed's own framing of its organization. No public headcount disclosure confirms this number |
| Credentialing volume | ~300 files per month | Average read off Imed's own dashboard during the interview |
| Finance to credentialing loop | About a week to a few hours | Reported by the credentialing area for the interdepartmental data request |
| Finance demand lead time | 2 to 3 days to about 1 day | Average card lead time of 1.059 days, read off the dashboard. A separate statement in the same interview puts resolution at "at most 8 hours" |
| Finance demand SLA | 3 hours | Tracked inside the app for specific subject types. Nothing was breaching at the time of the demo |
| Demand volume discovered | 260 in 3 months | Against an expectation of 30 to 35 per month. About 87 per month, roughly two and a half times what was assumed |
| Virtual reassessments scheduled | ~30 per day | Average, from a form living inside the hospital's own system |
| Automations in the quality flow | ~50, across 4 connected tables | The speaker's recollection for that single flow |
The 260 demands are not a productivity gain. They are a measurement. The finance department expected 30 to 35 requests a month. Three months after opening a single channel, it had 260. That difference was not created by the system. It was always there, spread across emails, phone calls and hallway conversations that nobody counted. The first thing a real operations system does is tell you how much work you have actually been doing. In the interview this was described as "almost double". The figures given put it closer to two and a half times.
Why priority by shift date matters more than it sounds. A credentialing queue sorted by arrival date will reliably fail the one file that matters, which is the physician scheduled to cover an intensive care unit on Friday night. Sorting by the shift date instead of the request date is a one-line rule that converts a backlog into a risk register.
The finance flow started as an NPS complaint. Imed runs an internal NPS survey. The finance department's score said people could not reach it. The response was not a policy or a training. It was one link, published to the hospitals, with everything behind it recorded. The system was built to answer a measured complaint, which is why it was adopted.
“Sometimes we're in a meeting and someone is asking for some kind of improvement, some kind of innovation, and the first thought is: let's throw it into Jestor and see if we can.”
What this case does not measure
Worth naming, because it is usually what gets inflated.
The interview says 72%. Jestor's own published summary says 71%. Neither states the cost base: what was counted, over what period, against what. It should be read as "the platform we stopped paying for was most of what that line cost", which is a real result and not a measured one.
It comes from one colleague's reported reaction: information that used to take two to three days arrived in two hours. In the same interview, the dashboard for that flow shows an average card lead time of 1.059 days. Both are true. The first is a best case someone noticed; the second is what the system actually averages. Anyone repeating the 24x figure as a typical result is misreading it.
It is how the company describes the scale of its own organization. Imed does not publish a headcount, and no independent source confirms this figure.
The obvious metric for a credentialing operation is what it costs to process one physician file. It was not measured before and is not measured now. Without it, none of the time savings converts into money.
Imed trains and supports hospitals toward clinical standards. It does not claim accreditation on its own behalf, and nothing in this case measures patient outcomes. What is measured is administrative throughput.
There is no written case, no customer survey and no third-party audit behind these numbers. The workflow descriptions and the dashboard figures were read off screen during a product walkthrough.
The speaker said "more or less 43". Separately, the company reports working with 43 hospitals. The two numbers are unrelated and the coincidence should not be turned into a sentence.
Physician staffing is a credentialing business wearing a clinical coat
| Indicator | Figure | Source |
|---|---|---|
| Emergency department visits staffed by an employer that is not the hospital system | ~67% | Health system owned employers account for 33.0% of visits. The rest sit with private equity owned groups (24.7%), regional clinician partnerships (20.8%), national clinician owned partnerships (13.4%) and single site partnerships (8.1%). Annals of Emergency Medicine, January 2026, covering 3,998 hospital based EDs and 109.7 million visits |
| Visits staffed by majority physician owned employers | 42.3% | Same study, as summarized by the American College of Emergency Physicians, August 2025 |
| Initial credentialing | 60 to 90 days, on a 20 to 30 item checklist | StatPearls, National Library of Medicine, updated February 2024 |
| Reappointment cycle | At least every 3 years | Same source |
| Medical groups behind on credentialing, recredentialing or reappointments | 32% | MGMA Stat poll, 5 November 2025, 131 medical groups |
| Cost attributed to a one day delay in provider onboarding | $10,122 | MGMA, August 2021, citing a 2019 physician revenue survey. Read the caveat below before using this |
| US locum tenens market | $9.6B in 2025 | Up from $9.1B in 2024, with $9.9B projected for 2026. Staffing Industry Analysts |
Two thirds of emergency department visits are staffed by an employer that is not the hospital system. That is the market Imed is in, and it explains why its core process is credentialing rather than care: the work of proving a physician is qualified to work in a building somebody else owns is the actual product being sold.
Sixty to ninety days for an initial file, twenty to thirty items to verify, repeated at least every three years, per physician, per institution. Run that against roughly five thousand physicians and forty three hospitals and it stops being a project with an end date. It is a permanent queue, and a permanent queue is exactly what a spreadsheet cannot hold.
The $10,122 per day figure is real and citable. It is also an annual average of hospital net revenue attributed to a physician, divided by working days, drawn from a 2019 survey that received 62 responses covering 93 hospitals, published by a different organization in 2021. It should never be multiplied across a 60 to 90 day credentialing window, though vendors do it constantly. The honest version of this point is MGMA's own, from its most recent poll: lost provider capacity is unrecoverable revenue. The association stopped attaching a dollar figure to it, and so does this case.
The locum tenens market is estimated at $9.6 billion in 2025 and growing four to five percent a year, while the largest publicly traded staffing company reported its physician segment down four percent in the same year. In a market that expands modestly and unevenly, margin comes from what it costs to run a placement, not from volume.
The system is built to fit, and stays our responsibility
One builder carries a request end to end, with one always in execution.
A new workflow, a new automation or a new dashboard comes in through the same channel without becoming a new project. In Imed's words, the first thought in a meeting became "let's throw it into Jestor and see if we can."
The credentialing app started as a kanban board, moved to a table view after the team said it worked better, and kept the board underneath for the people who still wanted it. That is what unlimited revisions buys.
Seats are never the meter, which matters when physicians, unit coordinators, hospital managers, finance, quality and HR all touch the same operation, and when some of them do not work for you.
People learn to use their app the way they learn any app, by opening it. Building, configuring and maintaining stays on our side.
Full export at any time, by CSV and API. SOC 2 compliant, no exit fee. Pause the building in one click and the systems keep running.
Methodology and sources
The workflow count, the savings figure, the credentialing volume, the demand counts, the lead times and all quotations come from a video interview given to Jestor, including an on-screen walkthrough of the live dashboards. The figures were read off those dashboards during the interview. None of it is independently audited.
The savings figure appears as 72% in the interview and 71% in Jestor's published customer summary. This case uses the published figure and names the discrepancy rather than choosing silently.
Physician count, hospital count, project count, service lines and the description of the virtual reassessment service come from the company's own public disclosures. The company states more than thirty years in medical group management; it does not publish a founding year, and no founding year is asserted here.
Annals of Emergency Medicine, "Emergency Physician Employer Market Share and Concentration by Ownership Type", January 2026, with the summary published by the American College of Emergency Physicians in August 2025. StatPearls, National Library of Medicine, "Credentialing and Privileging Provider Profiling", updated February 2024. MGMA Stat, "Confronting credentialing, reappointment crunch time in your medical practice", 5 November 2025, and MGMA Stat, August 2021, for the onboarding delay figure. Staffing Industry Analysts, US Locum Tenens Market Growth Assessment, 2025.
No competitor platform is named, because the interview does not name the one that was replaced. No accreditation claim appears, because Imed makes none on its own behalf. No credentialing delay cost is multiplied out into a headline figure, because the arithmetic that circulates for it does not hold.