When every product works but the case fails, the need for system performance readiness in connected surgery

Connected procedural care is increasingly evaluated product by product, although performance emerges from interactions across technologies, organizations, and clinical workflows. This paper proposes System Performance Readiness (SPR) as a capability for understanding system performance across product boundaries. Its defining requirement is that a connected procedural episode be reconstructable, so that any legitimate participant, whether a health system, manufacturer, clinician, or regulator, can understand how the connected system performed. Rather than creating a new regulatory layer or data platform, the framework specifies what a system should be able to know, who is responsible for the relevant evidence, and how learning can occur across platforms and sites. A reconstructable record of the connected episode makes it possible to understand how the system performed, so that learning, not blame, drives improvement.