At Primus we have a unique marriage of three fields of knowledge: medicine, business and mathematics. We know that by straddling these three domains we can solve many of the dogmatic inefficiencies plaguing healthcare.
We apply this philosophy to all of our consulting and software solutions - the same mathematical and operational underpinnings that can increase efficiency in an operating room supply chain can enhance patient access to care at the physician level.
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Jay Toor MD MBA
Founder
Although his clinical interest is Spinal Surgery, Jay’s professional passion is questioning the status quo of the healthcare system using evidence-based fundamentals. His clinical expertise allows him to generate ideas to apply business principles in novel ways to the field of healthcare
McMaster University BHSc 2010
University of Ottawa MD 2015
University of Toronto MBA 2019, Surgeon Scientist Training Program 2019, Orthopaedic Surgery 2022
Stanley Chung BComSci MBA
Partner
Stanley is an accomplished project manager with extensive experience leading client engagements to deliver data-driven results. He spent over five years in NYC where he was responsible for scaling and leading large, global software development and consulting teams in industries such as advertising, energy, and education.
He returned to his hometown of Toronto, where he completed his MBA at the Rotman School of Management, specializing in Operations Management and Statistics. Stanley received a Bachelor in Computer Science (Hons, Co-op) from the University of Waterloo and holds both Project Management Professional (PMP) and Certified ScrumMaster (CSM) designations. He brings a unique perspective to Primus by applying proven cross-industry best practices and a rigorous mathematical model-based approach to healthcare operations.
University of Waterloo BComSci. 2011
University of Toronto MBA 2019
Manjot Sangha
Partner
Coming Soon
Avneesh Bhangu BSc MD(c)
Project Manager
A Toronto native, Avneesh Bhangu graduated from The University of Western Ontario with a Bachelor’s in Medical Sciences, along with numerous accolades and distinctions. It was during his time at Western that Avneesh began to develop a fundamental understanding in how evidence-based research could be used to improve healthcare. Inspired by his desire to continue to improve patient care and hospital functioning, he joined Primus.
As a Project Manager and Senior Consultant with Primus, Avneesh managed his team of Associates and applied quantitative mathematical models to optimize several hospitals in the Greater Toronto Area. In collaboration with Dr. Jay Toor, he has gone on to submit several papers for publication on quality improvement and operations management.
Now an MD Candidate at Queen’s University School of Medicine, Avneesh hopes to achieve innovation by merging his passion for medicine and business. He plans to continue to address deficiencies within the healthcare system by applying evidence-based methods in the field of medicine.
University of Western Ontario BMSc. 2018
Queen’s University MD 2023
Jenny Du BSc MD(c)
Associate
After graduating from the University of Western Ontario, Jin Tong (Jenny) returned to Toronto as an MD candidate. Driven by her interest in quality improvement in medicine, she began working at Primus to expand her knowledge in hospital operations and their effects on patient care. Equipped with her experiences in scientific research, she hopes to contribute to the continuous improvement in Canadian Healthcare through her work at Primus.
University of Western Ontario BSc. 2017
University of Toronto MD 2021
We believe in evidence first. All of our solutions are backed by the most cutting edge science and we choose to publish our work in reputable peer-reviewed journals.
Publications and Presentations
Invited Guest Speaker
How Does Quality Improvement Fit into the Business of Healthcare? Faculty of Medicine Queen’s University Quality Improvement Series to Clerkship and Pre-Clerkship Medical Students. Scheduled January 2022.
Improving Efficiency in Surgical Care using Innovative Business Techniques. University of Toronto Division of Spine Surgery SPINEFEST Annual Meeting. June 14 2021.(https://www.youtube.com/watch?v=RlIuA25Vq1Y)
Using Business Techniques to Improve Perioperative Care: Saving Money and Increasing Efficiency. Special Rounds, Sunnybrook Health Sciences Centre Division of Orthopaedic Surgery. December 4 2020.
Surgeon’s Glance – Device Reprocessing and Standardization in the OR. Medical Device Reprocessing Association of Ontario Annual Meeting September 7 2019. (https://mdrao.ca/conferences/2019-conference/)
OR Optimization via Tray Reduction and Standardization Using Mathematical Modeling and Simulation Software. Operating Room Nurses Association (ORNGT) Meeting April 2 2019. (https://orngt.org/meeting/or-optimization-via-tray-reduction-standardization-using-mathematical-modeling-stimulation-software/)
Textbooks
Artificial Intelligence in Clinical Medicine – Chapter: Orthopedic Surgery. Wiley Publishing. Burns D, Abbas A, Toor J, Hardisty M. September 1 2021. Accepted and under review by Editor.
The Spine Book: Where Residents Learn Spine Surgery. Online open access (https://thespinebook.com/). Toor J, Yee N. January 1 2022. Under construction.
Peer Reviewer
Canadian Journal of Surgery (CJS). (https://canjsurg.ca). Expertise: Healthcare economics, healthcare management, health policy.
Health Management, Policy and Innovation (HMPI). (https://hmpi.org/). Expertise: Surgery, technology, procurement, supply chain, finance.
Mitacs Accelerate Entrepreneur Proposals. (https://www.mitacs.ca). Expertise: Surgery, medicine, entrepreneurship, artificial intelligence.
Publications
An Anesthesia Block Room is Financially Net Positive for a Hospital Performing Arthroplasty. Toor J, Saleh I, Abbas A, Abouali J, Wong P, Chan T, Sarhangian V. Submitted to the Journal of Arthroplasty. Accepted to Journal of the American Academy of Orthopaedic Surgeons January 2022.
Machine Learning using Preoperative Patient Factors Can Predict Duration of Surgery and Length of Stay for Total Knee Arthroplasty. Abbas A, Mosseri J, Lex J, Toor J, Ravi B, Khalil K, Whyne C. Accepted to the International Journal of Medical Informatics December 2021.
Perioperative Inventory Optimization Using Kotter’s Change Management Model. Toor J, Du J, Abbas A, Shah A, Bassi G, Morra D, Koyle M, Wolfstadt J. Joint Commission Journal on Quality and Patient Safety January 2022; 49(1) (https://pubmed.ncbi.nlm.nih.gov/34758922/)
Megaprosthesis Anti-Bacterial Coatings: A Comprehensive Translational Review. Koucheki R, Lex J, Stravropoulos N, Di Michele J, Toor J, Tsoi K, Ferguson P, Turcotte R, Panagelopoulos P. Acta Biomaterialia Dec 2021 5;S1742-7061(21)00794-7 (https://pubmed.ncbi.nlm.nih.gov/34879295/)
Value Based Total Cost of Ownership vs Traditional Pricing in Procurement: A Case Study Using Orthopaedic Powered Instruments. Abbas A, Du JT, Whyne C, Mitchell W, Toor J. Accepted to Health Management, Policy, and Innovation August 2021 (https://hmpi.org/2021/12/02/value-based-procurement-using-total-cost-of-ownership-a-step-by-step-financial-assessment-of-orthopaedic-powered-instrument-procurement/)
Optimizing the Orthopaedic Surgical Tray to Immediately Increase Efficiency and Lower Costs in the Operating Room. Toor J, Bhangu A, Wolfstadt J, Bassi G, Chung S, Rampersaud R, Mitchell W, Milner J, Koyle M. Accepted to Canadian Journal of Surgery April 2021
Using Operational and Monte Carlo Modeling Techniques to Predict Financial Performance in a Tertiary Care Outpatient Clinic. Di Cesare R, Toor J, Wolfstadt J, Chung S, Rampersaud R, Milner J, Koyle M. Urology Practice July 2021 Apr 23:10-97. (https://www.auajournals.org/doi/10.1097/UPJ.0000000000000235)
The unique impact of COVID-19 on Orthopaedic surgery residency applicants and program directors in Canada. Shah A, Champagne A, Del Papa J, Toor J, Larouche J, Nousiainen M. Canadian Journal of Surgery April 21;64(2):E249. Doi: 10.1503/cjs.002021 (https://pubmed.ncbi.nlm.nih.gov/33881278/)
Delivery of Local Antibiotics via Calcium Sulfate Beads for Chronic Osteomyelitis with a Simple, Novel Surgical Technique. Lex J, Toor J, Spurr H, Cloutier J, Kreder H. Orthopaedics December 2021; 36(4) 547-549 (https://journals.lww.com/techortho/Fulltext/2021/12000/Intramedullary_Delivery_of_Local_Antibiotics_Via.48.aspx)
Saturated Salt Solution Cadaver-Embalming Method Improves Orthopaedic Surgical Skills Teaching. Burns D, Bell I, Toor J, Katchky R, Safir O, Dwyer T. J Bone Joint Surg Am. 2018 Aug 1;100(14). (https://pubmed.ncbi.nlm.nih.gov/30063602/)
Pediatric Glass Fronted Fireplace Burns in Canada: A Growing Issue Over the Past Twenty Years. Toor J, Crain J, Kelly C, Verchere C, Fish J. J Burn Care Res. 2016 Sep-Oct; 37(5):e483-488 (https://pubmed.ncbi.nlm.nih.gov/27031430/#:~:text=A%20total%20of%20616%20cases,children%20less%20than%205%20years.)
Does Computed Tomography Change Our Observation and Management of Fracture Non-Unions? Kleinlugtenbelt Y, Scholtes V, Toor J, Amaechi C, Maas M, Bhandari M, Poolman R, Kloen P. Arch Bone Jt Surg. 2016 Oct;4(4):337-342. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100449/#:~:text=They%20found%20that%20additional%20CT,which%20previous%20radiographs%20were%20equivocal)
Erratum re: The Accuracy of Computed Tomography for the Diagnosis of Tibial Nonunion. Bhattacharyya T, Bouchard K, Phadke A, Meigs J, Kassarjian A, Salamipour H. Toor J, Kleinlugtenbelt Y. J Bone Joint Surg Am. 2016 Apr;88(4):692-697. (https://pubmed.ncbi.nlm.nih.gov/16595457/)
Manuscripts Submitted
Clinical Applications of Augmented Reality in Orthopaedic Surgery. Koucheki R, Lex J, Toor J, Backstein D. Invited submission to the Journal of the American Academy of Orthopaedic Surgeons.
The efficacy of primary sacroiliac joint fusion for lower back pain caused by sacroiliac joint pathology: a systematic review and meta-analysis. Abbas A, Du J, Toor J, Versteeg A, Finkelstein J. Submitted to the European Spine Journal.
The COVID-19 Pandemic: A Destabilizing Force to Improve the CaRMS Match in Orthopaedic Surgery and Beyond; a National Survey. Shah A, Champagne A, Del Papa J, Toor J, Larouche J, Nousiainen M. Submitted to the Canadian Medical Education Journal.
Standardization of Laparoscopic Trays Using an Inventory Optimization Model to Produce Immediate Cost Savings and Efficiency Gains. Toor J, Shah A, Abbas A, Du J, Kennedy E. Submitted to PLOS One.
A Dedicated Orthopaedic Trauma Room Improves Efficiency While Remaining Financially Net Positive. Lex J, Abbas A, Oitment C, Wong P, Abouali A, Yee A, Kreder H, Larouche J, Toor J. Submitted to Journal of Orthopaedic Trauma.
Manuscripts In-Progress
Optimizing Orthopaedic Surgery Resident Scheduling using Machine Learning. Abbas A, Toor J, Du J, Versteeg A, Yee N, Finkelstein J, Abouali J, Nousiainen M, Whyne C, Larouche J. Submission pending final review by co-authors.
Machine Learning Algorithms to predict publication rates of the North American Spine Society Annual Meeting Abstracts. Abbas A, Olotu O, Bhatia A, Toor J, Selimovic D, Finkelstein J, Larouche J, Ahn H, Lewis S. Submission pending final review by co-authors.
Key Stakeholder Perceptions of Standard vs Total Cost of Ownership Procurement Analysis for Orthopaedic Powered Instruments. Abbas A, Olutu O, Morra D, Toor J. In preparation.
Optimizing spine surgery instrument trays: Comparison of popular optimization techniques. Belhouari S, Toor J, Koucheki R, Abbas A, Larouche J. In preparation.
Forecasting orthopaedic surgery on-call working hours using predictive analytics on temporal and climatic features. Yee N, Abbas A, Olotu O, Finkelstein J, Larouche J, Whyne C, Toor J. In preparation.
Process familiarity produces immediate cost savings and efficiency gains. Du JT, Abbas A, Whyne C, Mitchell W, Toor J. In preparation.
Diversion of Surgical Patients to In-office Needle Arthroscopy: Reducing Costs and Increasing Efficiency. Abbas A, Shah A, Lex J, Abouali J, Toor J. In preparation.
Investigating patient and surgeon perceptions of In-Office Needle Arthroscopy (IONA) as an alternative to traditional surgical arthroscopy for partial medial. Shah A, Toor J, Abbas A, Abouali A. In preparation.
How to make the most of your operative time: Bin Packing for Elective OR Scheduling. Toor J, Saleh I, Abbas A, Wong P, Abouali J, Sarhangian V, Chan T. In preparation.
Presentations
Machine Learning Models Can Predict Subsequent Publication of North American Spine Society Annual General Meeting Abstracts. Toor J, Abbas A, Olutu O, Larouche J, Lewis S. Podium presentation at the Global Spine Congress, June 2022.
Optimizing Spine Surgical Scheduling Using Integer Linear Programming. Toor J, Abbas A, Larouche J, Yee A. Podium presentation at the Global Spine Congress, June 2022.
An Anesthesia Block Room is Financially Net Positive for a Hospital Performing Arthroplasty. Toor J, Saleh I, Abbas A, Abouali J, Wong P, Chan T, Sarhangian V. Podium presentation at the Annual Meeting of the American Academy of Orthopaedic Surgeons, March 2022.
How to make the most of your operative time by optimizing surgical scheduling. Toor J, Abbas A, Saleh I, Wong P, Abouali J, Sarhangian V, Chan T. Poster presentation at the Annual Meeting of the American Academy of Orthopaedic Surgeons, March 2022.
A case study of successful change management in the perioperative care department: Using Kotter’s Change Model to implement inventory optimization. Toor J, Du J, Abbas A, Shah A, Bassi G, Koyle M, Wolfstadt J. Poster presentation at the Annual Meeting of the American Academy of Orthopaedic Surgeons, March 2022.
A dedicated Orthopedic Trauma Room improves efficiency while remaining financially net positive. Lex J, Abbas A, Wong P, Abouali J, Larouche J, Yee A, Toor J. Poster presentation at the Annual Meeting of the American Academy of Orthopaedic Surgeons, March 2022.
Machine Learning to Predict Duration of Surgery and Length of Stay for Single Level Discectomy Procedures. Toor J, Abbas A, Finkelstein J, Lewis S, Yee A, Whyne C , Larouche J. Podium presentation at the Annual Scientific Conference of the Canadian Spine Society, February 2022.
Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating room. Belhouari S, Toor J, Abbas A, Brooks H, Larouche J. Podium presentation at the Annual Scientific Conference of the Canadian Spine Society, February 2022. (https://www.thespinejournalonline.com/article/S1529-9430(21)00549-0/pdf)
How spine surgeons can make the most of their operative time: surgical schedule optimization. Toor J, Saleh I, Abbas A, Ahn H, Whyne C, Finkelstein J, Yee A, Larouche J. Podium presentation at the Annual Scientific Conference of the Canadian Spine Society, February 2022.
Predicting Analytics to Improve Dedicated Spine Trauma Operating Room Resource Allocation. Toor J, Abbas A, Whyne C, Finkelstein J, Larouche J, Yee A. Podium presentation at the Annual Scientific Conference of the Canadian Spine Society, February 2022.
Machine Learning Models to Predict Surgical Resident Workload at a Level 1 Trauma Center. Abbas A, Toor J, Whyne C, Finkelstein J, Larouche J. Poster presentation at the Annual Scientific Conference of the Canadian Spine Society, February 2022.
The efficacy of primary sacroiliac joint fusion for lower back pain caused by sacroiliac joint pathology: a systematic review and meta-analysis. Toor J, Abbas A, Du J, Versteeg A, Finkelstein J. Podium presentation at the North American Spine Society Annual Meeting, October 2021. (https://www.sciencedirect.com/science/article/pii/S152994302100351X#)
A Case for the Use of Machine Learning Algorithms to Optimize Resident Call Scheduling. Abbas A, Toor J, Abouali J, Larouche J, Kreder H, Nousiainen M. Podium presentation at the International Association for Medical Education Meeting, August 2021.
Standardization of the Laparoscopic Surgical Tray. Du K, Abbas A, Shah A, Toor J. Poster presentation at Society of Laparoscopic and Robotic Surgeons Annual Meeting, July 2021.
Machine Learning Models to Improve Spine Trauma Operating Room Scheduling. Toor J, Abbas A, Versteeg A, Larouche J, Finkelstein J, Nousiainen M. Poster presentation at International Meeting of North American Spine Society, July 2021.
Innovative Business Tools to Improve Resident Wellness: Optimizing on-call scheduling using machine learning. Toor J, Abbas A, Du JT, Versteeg A, Shah A, Abouali J, Larouche J, Nousiainen M. High scoring poster presentation at the Annual Meeting of the Canadian Orthopaedic Association, July 2021.
Optimizing the Orthopaedic Surgery Instrument Tray to Immediately Increase Efficiency and Lower Costs in the OR. Toor J, Bhangu A, Bassi G, Chung S, Koyle M, Wolfstadt J. High scoring poster presentation at the Annual Meeting of the Canadian Orthopaedic Association, July 2021.
Lowering costs in Spine Surgery While Increasing Efficiency: Optimizing the Spine Instrument Tray. Toor J, Abbas A, Du JT, Versteeg A, Abdool K, Yee A, Larouche J. Poster presentation at the Annual Meeting of the Canadian Orthopaedic Association, July 2021.
Differing Post-Operative Neurologic Injury Rates Based on Level of Upper Instrumented Vertebral Level in Adult Spinal Deformity. Toor J, Ravinsky R, Keshen S, Magee C, Lewis S. Poster Presentation at Annual Meeting of the North American Spine Society, September 2018.
Cadaver Embalming Methods for Orthopaedic Surgical Skills Training. Toor J, Burns D, Bell I, Katchky R, Safir O, Dwyer T. Poster Presentation at Canadian Orthopaedic Association, June 2018.