Published Nov 10, 2026

Opening a new surgery center or office‑based lab: the IT and low‑voltage timeline

A phase‑by‑phase IT and low‑voltage plan for opening an ambulatory surgery center or office‑based lab, from construction drawings to your first case.

Dale Calvin

Founder & CEO

The short answer: A new ambulatory surgery center typically takes 18 to 24 months from site selection to first case. IT and low‑voltage work runs through all of it: the telecom room belongs on the first drawings, internet service should be ordered as soon as the site is certain, cabling goes in before the walls close, and every system has to be tested before the state's final inspection and your accreditation survey. Most IT delays come from starting too late, not from the work itself.

The published timelines for opening a surgery center are good at licensing, accreditation and payer contracting. Most of them treat technology as a single line, "select software" or "office equipment," a few months before opening. That's the gap that pushes opening dates. Network rooms that are too small, missing data drops, internet circuits that aren't live, imaging equipment that can't find its worklist: each one is easy to prevent and expensive to fix late.

This guide lays out the IT and low‑voltage work for a new ambulatory surgery center (ASC) or office‑based lab (OBL), in the order it has to happen.

The timeline at a glance

Count backward from the first case. Industry sources put a new surgery center at 18 to 24 months from site selection to opening; the phases below are the ones every project goes through, whatever its exact dates.

Phase	Project milestones	IT and low‑voltage work
Planning (about 24–18 months out)	Site selection, architect, feasibility	Add a technology lead to the design team. Decide whether the space must meet ASC specifications now or later.
Design and plan review	Construction documents; state plan review (in Texas, HHSC's Architectural Review Unit)	Telecom room on the drawings with power and cooling. Low‑voltage design: drops by room, Wi‑Fi access points, pathways, nurse call, access control, cameras.
As soon as the site is certain	Lease or purchase signed	Order internet service, primary and backup. Plan phone and fax number porting.
Before construction ends	Software and equipment selection, payer contracting	Select the clinical software and imaging systems. Ask device vendors for security documentation. Plan interfaces.
Construction: rough‑in	Walls and ceilings open	Pull cable, set pathways and back boxes, firestop rated walls.
Construction: trim‑out	After drywall	Terminate, label and certify every drop. Build out the telecom room.
Final inspections and licensing	Certificate of occupancy, state final inspection, license	Internet live. Firewall, switches and Wi‑Fi up. Access control, cameras, phones and nurse call installed and tested before the final inspection.
Last 30 days	Staff training, equipment in place, dry runs	Workstations, printers and scanners ready. Interfaces, worklists and image routing tested with test patients. Vendor remote access set up. Every login checked, downtime procedures printed, support scheduled for day one.

The exact months shift with your state, your accreditor and your landlord. The order doesn't.

Why IT gets missed

It's not on the timeline. The opening checklists we reviewed, from software vendors, equipment makers, consultants and industry publications, cover licensing, accreditation and contracting in detail. Most mention technology only as software selection or office equipment, and none lists network, cabling, internet or phone milestones.
Nobody owns the pathways. Low‑voltage work is one of the most often fragmented scopes in commercial construction, and who provides conduit and cable tray, the electrician or the cabling contractor, is a classic gap between the general contractor and the low‑voltage trade.
Wi‑Fi is placed last. Access point locations decided after rough‑in mean opened ceilings and new cable runs. Contractors cite it as a leading cause of low‑voltage rework.
The handoff is undefined. Without a defined closeout package (test reports for every drop, labels that match at both ends, as‑built drawings), whoever supports the site afterward spends weeks reconstructing what was installed.

All four are planning problems. None of them is solved by a better installer on day 300.

Design: what has to be on the drawings

The decisions with the longest reach are made before construction documents go to plan review.

A real telecom room. The healthcare cabling standard, ANSI/TIA‑1179‑B (2023), sets the minimum telecom room size at 170 square feet. Give it dedicated circuits, cooling sized for the equipment, and a door that locks. A storage closet with a shelf is not a telecom room.
The right cable. TIA‑1179 sets Category 6A as the minimum for healthcare cabling, and TIA‑1179‑B requires two Category 6A (or better) runs to every wireless access point. That affects cable counts and pathway fill, so it belongs in the design, not the change orders.
Access points inside shielded rooms. Lead‑lined walls in rooms with fluoroscopy or X‑ray block much of the Wi‑Fi signal. Plan an access point inside each shielded room rather than counting on coverage from the corridor.
Drops for every device, plus spares. Map drops from how each room will be used, not from the furniture plan. Each procedure room needs drops for its workstations, anesthesia equipment, imaging workstations, wall displays and phone; pre‑op and recovery bays, nurse stations, check‑in and offices need theirs. Add spares; a drop pulled now costs far less than one added after drywall.
Pathways and back boxes for card readers, cameras, intercoms and nurse call stations, coordinated with the door hardware and ceiling plans.
Power for the network. Ask your electrical engineer which IT and communication loads go on emergency power, and size a UPS so the firewall, switches and phones ride through a power transfer.

If the space might convert from an office‑based lab to an ASC later, build the IT to ASC specifications now. Re‑cabling an occupied facility is far more disruptive than doing it right during construction.

What to order when

Some lead times have nothing to do with how fast your team works.

Internet service. If the building is already on a carrier's network, installation can take about 30 days. If the carrier has to build to the site, expect 60 to 120 days or more, and permitting can stretch it further. Order as soon as the site is certain, and order a backup connection from a different provider.
Phone and fax numbers. Porting numbers from an existing location typically takes about 30 days. Start it with the internet order.
Clinical software. Implementation is usually measured in months, not weeks. One health center technical assistance resource estimates 60–90 days for the first provider. Interface builds between systems often take several weeks each.
Imaging and modality installs. Vendors schedule installation and applications training on their own calendars. Book them as soon as the equipment is ordered, and ask what network and room readiness they need first.
Access control and cameras. Card readers depend on the door hardware schedule, so order them with the doors.

Connecting imaging equipment

In a cath lab, vascular lab or any procedure room with imaging, the integration chain has a strict order:

Registration and orders flow from the scheduling or practice management system (HL7).
The modality worklist gives each device, such as a C‑arm, ultrasound or intravascular imaging system, the day's patients, so staff don't retype demographics (DICOM Modality Worklist).
Images and reports are sent to the image archive (PACS) or cardiovascular information system.

Each step depends on the one before it, and each depends on the network. The common failures are small and specific: a one‑character mismatch in a device's DICOM name (its AE title) returns an empty worklist; firewall rules lost when the network is segmented block traffic; a blocked DICOM port stops images from arriving. Test the whole chain with a test patient on every device before the first real one.

Two more items for every networked medical device:

Ask for the security paperwork before purchase: the manufacturer's MDS2 form (Manufacturer Disclosure Statement for Medical Device Security) and its software bill of materials. For new networked devices, FDA requires manufacturers to include a software bill of materials in their premarket submissions.
Set up vendor remote access deliberately: who connects, how, and with what logging. Leaving it to the installer on day one usually means an open door nobody tracks.

The systems beyond the network

A surgery center's low‑voltage scope is wider than computers and Wi‑Fi:

Nurse call and staff emergency call. In Texas, ASC rules (26 TAC §508.52) require a nurse emergency call station in every patient toilet, with a signal that repeats every five seconds and can be canceled only at the patient's station, and a staff emergency assistance station in every operating, treatment, examination, recovery and pre‑op area, with dome lights over the doors and at corridor intersections.
Access control, with card readers on clinical, pharmacy, records and telecom room doors.
Video surveillance and intercom, typically IP cameras recording to a network video recorder and a video intercom at the entrance.
Phones and paging, usually VoIP, with power over Ethernet and a plan for when the internet is down.
Fax, which many referral and payer workflows still depend on.
Cellular coverage, which can be weak inside shielded rooms and large buildings; test it before staff rely on it.

Before the final inspection and survey

The last month is where IT readiness meets regulators.

Texas final inspection. HHSC's Architectural Review Unit must sign off a final inspection before patients can occupy the facility, and the state's ASC rules require nurse call and communication systems to be tested. Treat those systems as finished before the inspection, not after.
Emergency communications. Medicare's emergency preparedness rule for ASCs (42 CFR 416.54) requires "primary and alternate means" of communicating with staff and emergency management agencies, and a documentation system that keeps patient records confidential and available. A backup internet connection and a phone plan that survives an outage are part of the answer.
Security from day one. Encrypt devices, turn on multi‑factor authentication, set up backups and run a HIPAA risk analysis for the new site before patient data arrives. Our guide to the HIPAA Security Rule update covers what's required now. In Texas, also confirm that every system storing patient records keeps them in the US, as SB 1188 requires.

Office‑based lab, ASC or medical office

	Office‑based lab	Ambulatory surgery center	Medical office
How it's regulated	Physician office, paid under the physician fee schedule; generally no separate state facility license	State license where required (Texas: HHSC) and Medicare Conditions for Coverage, with a state or accreditation survey	Physician office
IT and low‑voltage scope	Procedure rooms with imaging integration, network, security	Everything an OBL needs, plus nurse and staff emergency call, emergency communication requirements and survey readiness	Network, phones, workstations, security
Planning note	Build to ASC specifications if you may convert later	Plan IT around plan review, final inspection and survey	Order internet early; the rest is shorter

Medicare doesn't allow an office‑based lab and an ASC to operate in the same space at the same time, so hybrid models separate them by day or by floor. That has network consequences: shared rooms, shared devices and shared systems need to be set up with the split in mind.

Questions for your architect and general contractor

Where is the telecom room, how big is it, and does it have dedicated power and cooling?
Who provides conduit, cable tray and back boxes: the general contractor or the low‑voltage contractor?
When does rough‑in start, and how long is the window before drywall?
Where are the Wi‑Fi access points, including inside shielded rooms?
Which IT and communication systems are on emergency power?
Who coordinates card readers with the door hardware schedule?
What will we receive at closeout: test reports for every drop, a labeling scheme and as‑built drawings?

Day one and the handoff

Opening day is the start of support, not the end of the project.

Be in the building. Plan for support staff on site for the first cases: logins, printers, label printers, scanners and the worklist are where day‑one issues show up.
Print the downtime procedures. Every room should know what to do if the network or the clinical software goes down.
Hand over a complete package: the closeout documents above, an inventory of every device, admin credentials stored securely, vendor contacts and support agreements, and a network map. Whoever runs IT after opening, in‑house or a managed services partner, needs it on day one.

Here's how one vascular group's new clinic and procedure center opened on schedule with this approach.

Frequently asked questions

How long does it take to open an ambulatory surgery center?

Typically 18 to 24 months from site selection to opening, according to ASC development and software sources. Licensing, accreditation and payer contracting set most of the pace, but IT and low‑voltage work has to start in the design phase to keep up.

When should IT be involved in building a surgery center?

During design, before construction documents go to plan review. The telecom room, cable pathways, Wi‑Fi locations and low‑voltage systems all need to be on the drawings.

When should I order internet for a new medical facility?

As soon as the site is certain. Installation can take about 30 days where the carrier already serves the building and 60 to 120 days or more where it has to build, so ordering late is one of the most common reasons a new site opens without working internet.

What is the difference between an office‑based lab and an ASC?

An office‑based lab is a physician office paid under the Medicare physician fee schedule and generally doesn't need a separate state facility license. An ASC is a licensed facility (where states require it) that must meet Medicare's Conditions for Coverage and pass a state or accreditation survey. Medicare doesn't allow both to operate in the same space at the same time.

What IT and low‑voltage systems does a new surgery center need?

Structured cabling, a telecom room, the network (firewall, switches, Wi‑Fi), internet with a backup, phones and fax, nurse and staff emergency call, access control, cameras, workstations and printers, clinical software, imaging integration, and backup and security controls.

What cabling should a new surgery center use?

The healthcare cabling standard, ANSI/TIA‑1179‑B, sets Category 6A as the minimum and requires two Category 6A runs to every wireless access point. Confirm the specification with your designer early, because it affects pathways and cable counts.

Does Wi‑Fi work in rooms with lead shielding?

Often poorly. Lead‑lined walls block much of the signal, so plan an access point inside each shielded procedure room.

Every facility is different, and your state's rules, your accreditor and your landlord will shape the details. If you're planning a new surgery center or office‑based lab, tell us what you're building.

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