FAQS-2

There are two different locations in SurgicalPerformance where your records are listed. In order to search for a specific record you must first be in the correct place to do so.

How to search for a record:

1. Click on "INSIGHTS"

2. click on the module you wish to search.  Our example is Gynaecology.

3. You will then find the search field and filter options.

How NOT to search for a record:

Your "Dashboard" is a snapshot of your SurgicalPerformance account. You can see records, but you cannot do much with them.

If you click on the different modules on your dashboard, it changes the pie graph accordingly and shows you a snapshot of the most recent records. You CANNOT search for your records here.

A safety feature of SurgicalPerformance is automatically logging you out after a period of inactivity. This is to protect your data from any prying eyes, and prevents the entry of data by someone else (if on a shared computer for example). You can simply sign back in to pick back up from where you left off.

Head to your settings page once logged in.

Then on your Profile tab there is a field to update your email address.

Once you have entered your updated email address, do not forget to click "Update" at the bottom of that section.

In order to review outcomes or reports you need to have registered a valid institution/location and all mandatory data fields (highlighted in RED) need to be complete.

To review outcomes click on the “REPORTS” button

select your module (e.g., “Gynaecology” or “Obstetrics”).

In order to view reports, you need to select one option from each of the four pull down menus.

Report Group – you can chose to review reports on general patient information, general outcomes, or a specific procedure. Selecting one group of reports will determine the choice of outcome variables in the window to the right (“OUTCOME”).

Outcome – chose the outcome you are interested in

Institution/Location – chose one of your nominated institutions/locations

Time frame – chose between four time periods. Only cases within these time periods will be counted

Click "Generate Report"

Example:

Note: an extra filtering field has appeared so you can further look into your results.

If you wish to further analyse your data in a way that SurgicalPerformance does not facilitate, please export all of your raw data into an excel document where you can then filter and graph anything you wish.

Here is a guide to help you with this: http://help.surgicalperformance.com/en/articles/3428113-how-can-i-export-data-and-filter-in-excel

First thing is to make sure you have a complete registered account, and you are able to log in with the username and password that you chose.

Once you are logged in, you will be asked to add a location. You will be unable to add any records unless you add a location first. This is because all of your outcomes are based around your location at which the surgery was performed. You can have as many locations as you like.

After you have selected your location, simply click on "add record" and start entering your data.

Another reason you may not be able to enter data is if you were on a trial subscription, which offers you 10 free records. After those 10 records have been used up, you will no longer be able to enter data unless you upgrade to the INSIGHTS or paying plan. This can be done through your settings page.

If you have any other troubles entering data please let us know.

Overall, we have provided the most common procedures performed within Obstetrics and Gynaecology. However, that does not mean we are not looking for ways to improve or enhance our users experience.

So if you have a procedure that you perform quite regularly and feel it may benefit other users also, please be in touch so we can get some details off you and we will hopefully be able to add it in.

This also applies to if a procedure already exists but you feel other options should be available within that procedure, reach out and we can have a chat about improving the data fields.

If it is an edge case, or a one off stranger than normal procedure, we recommend documenting it within the closest related procedure available on SurgicalPerformance. There is always a place for free text when entering data.

Contact us via Intercom - little blue speech bubble at the bottom right of the screen
Email: [email protected]

SurgicalPerformance users sometimes ask why certain co-morbidities are not captured in our databases. For example, hypertension is very common but in SurgicalPerformance we don’t record it.

In SurgicalPerformance we record surgical procedures, clinical outcomes and also confounders of outcomes, such as medical co-morbidities, body mass index, ASA score and age. These confounders are often overlooked but can have a profound impact on the risk of surgical complications.

However, not all medical co-morbidities are associated with poor clinical outcomes.

Mary Charleson, a physician from Cornell University in New York researched what types of medical conditions were associated with patients’ death during their hospital stay.

She identified 19 medical conditions and weighed them according to their severity. More severe co-morbidities and a higher number of co-morbidities resulted in a higher score. Since then a number of publications confirmed that a higher Charleson score relates to a higher risk of death.

Since then the use of the Charleson index has been expanded to predict postoperative, surgical complications and has been validated (including by our group) several times. In one of our papers on laparoscopic versus open endometrial cancer surgery, the Charleson index had an independent and significant impact on the risk of postsurgical complications.

The major breakthrough of the Charleson score is that medical co-morbidities are captured in a structured way by selecting only 19 medical co-morbidities from a very long list. Would we record medical co-morbidities in an unselected way, we would need to work through a very long list every time we record patients details.

While hypertension is common, it is irrelevant in regards to surgical outcomes. In SurgicalPerformance we simply tick the relevant boxes and we are reassured that we capture clinically relevant information.

Identifiable SurgicalPerformance data will not be shared with anyone. Neither the hospital (health care institution), nor any other third party (College, AHPRA, professional societies, etc) will be able to identify an individual specialist or its SurgicalPerformance data. SurgicalPerformance data is not even available to the courts because it is protected by Qualified Privilege.

However, institutions who purchase SurgicalPerformance for their accredited health practitioners will know how many accredited specialists sign up and participate, but it will not be able to identify these specialists.

SurgicalPerformance is data safe by all established standards. All data transfer from and to our servers is encrypted and protected from interference with third parties. We use Amazon Web Services, which is also used by a number of US based health care institutions and which is HIPAA compliant. For detailed information see our Data Protection Policy.

SurgicalPerformance is an independent Australian company without ties to AHPRA. RANZCOG and RACS provide professional recognition for continuing professional development. Professional societies may engage with SurgicalPerformance in promoting self-audit to its members and becoming institutional customers of SurgicalPerformance.

If you need help with anything, have feedback to provide, or a special request, please do not hesitate to reach out to us.

• Intercom - the little blue speech bubble in the bottom right of your screen is a quick and easy way to shoot us a message, we will reply as soon as we get a chance. (These messages gets sent to everyone on the team unless you select someone specific, however, someone different may reply).
• Email - [email protected]

  - [email protected]
  - [email protected]
  - [email protected]

• Text or Call - 0484 000 408

While an institution (hospital) encourages the clinical independence of accredited health professionals and acknowledges the accountability that accompanies this independence, it also has a vital interest in the standard of health care practised, as this determines the quality of care received by patients and ultimately its reputation.

While health care operators (hospitals) often don’t see themselves monitoring standards of independent medical practice, they would acknowledge that various stakeholders including patients have an intense interest in these standards being monitored and where necessary improved.

Therefore, an increasing number of hospitals and health care operators look into self-audit by its accredited specialists, conducted confidentially and at arm’s length from the institution itself to achieve this crucially important end.

No identifiable user information will be provided to any institutions

The ‘date of first diagnosis’ is the first time you have met with the patient and have a diagnosis..

In some instances, you may not have a diagnosis until the day of surgery if it is a diagnostic procedure. And for some other cases, patients may have had a diagnosis months ago but by a different doctor or surgeon, and they may have been referred to you. you may not know that original date of diagnosis so the first time you met with them will be fine.

If you do not know the original date of diagnosis, we suggest you use the date of the first time you met with them.

If you still have questions or concerns regarding this, please contact us via Intercom (speech bubble bottom left of the screen).

No, records cannot be deleted, even if you make a mistake or enter a record twice. A feature of modern medical databases is that records (cases) cannot be deleted. It is meant to protect users from being accused of falsifying records. However, users can overwrite those records. An audit log will record the details of when and where those changes have been made.

There is a function on Version 3 of SurgicalPerformance where you can "Hide" a record. This could be used if you wanted to remove a double entry. However it will not be deleted from your account, simply hidden.

Since 1 December 2017, the new Australian National Cervical Cancer Screening program mandates by Federal law that gynaecologists submit data about colposcopies to the National Cancer Screening Register (NCSR).

SurgicalPerformance modified its data fields to be consistent with the data fields implemented in the NCSR, which is operated by Telstra Health.

SurgcialPerformance users can opt into this service for their colposcopy entries and therefore fulfil their legal obligations requirement.

Here we address some of the questions we’ve been receiving from our users recently:

1. Should colposcopy data prior to 1 DEC 2017 submitted to the NCSR?

No. Only Colposcopies performed in Australia on or after 01 Dec 2017 are eligible for entry into NCSR.

2. I do most colposcopies in my rooms. Do I need to register my rooms as an institution?

Yes, entering data into SurgicalPerformance requires a practice location because all outcomes will be presented by practice location.

Once you are logged intoSurgicalPerformance, you go to your profile (top left of the screen) select “Locations”, start typing "private rooms" and then select the one that is within your state.

3. How can I physically submit data to the NCSR through SurgicalPerformance?

It is the health practitioner’s responsibility to complete the record within the colposcopy module. Users can either instantly generate the NCSR report from the bottom of that page, or save and generate it at a later date.

To do it later, simply click on the colposcopy records, find the case you wish to report on. Click on the little 3 dots at the end of the row and click NCSR report. Then a window will open that will require you to provide information on the patient and yourself. The information about yourself can be saved so that you don’t need to enter that every time. Information about the patient and the colposcopist are mandatory.

Once that information is entered you click “Generate "PDF". It will automatically download to your computer. If it doesn't automatically open - check your downloads folder. You can then print it and either fax it or post it to the locations listed on the form.

4. What options other than SurgicalPerformance do I have to submit my colposcopy data to the NCSR?

If you are not a SurgicalPerformance Premium user, you can download the Colposcopy and Treatment form from this website, complete it by hand and submit it in a method similar to the above.

5. What is the advantage of submitting colposcopy data through SurgicalPerformance?

There are two major advantages:

a. Apart from being compliant with legislation, you will also have full electronic access to your colposcopy procedures and treatment outcomes. These outcomes are available 24/7 and users of SurgicalPerformance will be able to compare themselves with other users in Australia while full confidentiality is maintained. You will also earn CPD points.

b. For medical practitioners and their staff who are used to a paperless administration, it will be quicker to complete these forms electronically rather than by hand.

Should you have any further questions or require any support, please contact us via the little speech bubble on the bottom left of your screen, email [email protected], [email protected], or [email protected] or text or phone 0484000408– available 24/7.

No, because audit is part of the clinical routine service provision.

Human Research Ethics Committee (HREC) review is only required for research but clinical (surgical) audit does not constitute research as such. The National Statement on Ethical Conduct in Human Research (2007, revised in 2009) does not suggest that data, whether identifiable or not, collected in a database is a research activity. Rather, the National Statement only applies when that data is to be used in what would be recognised as a research activity. Even then, there are instances when such usage may be considered low or as negligible risk research that do not require review by a HREC.

The use of SurgicalPerformance requires collection of data by participating clinicians and only they have access to their own data. Other users can not access any other data. Summaries of overall performance from the whole data set are provided in a completely de-identified aggregate manner from which it is impossible to identify either individual patients or participating clinicians.

Due to the sensitive nature of the data collected it is not proposed that the raw data set be used by anyone outside of the participating clinicians and it is emphatically not a ‘research’ database. External researchers will not have access to this data therefore there is no requirement for Human Research Ethics Committee (HREC) review.

Surgical audit is recognised internationally as a critical component of steps aimed at enhancing quality and safety in surgical practice. The ethical question should be “why is this not being done routinely?” as a lack of such data will place patients at potential risk through a lack of checks aimed at improving patient safety.

If users wish to use data for research (to be published), an HREC application is required. In most instances a low-risk application would suffice.

It is legal to enter de-identified patient data. SurgicalPerformance undertakes all necessary steps to prevent the data from being interfered with from unauthorised persons. Despite all efforts, it could happen. Therefore, you must not enter patient names or any other information that could identify a patient.

No, SurgicalPerformance will not report outcomes to third parties at anytime unless required by law. See our privacy policy.

YOUR OWN DATA

You will always have 24/7 access to your own data, which you can download into an Excel spreadsheet.

OTHERS’ DATA

If you wish to get access to other users’ data, you will need to make a submission to SurgicalPerformance [email protected] and apply. You will only receive de-identified data that will not allow patients or contributing clinicians to be identified.

We recommend that you disclose audit activities to patients as part of your practice’s Privacy Policy as a matter of administrative routine. However, there is no need to get audit approved by the hospital, the College or patients.

The Australian Commonwealth has granted “Qualified Privilege” to SurgicalPerformance in May 2015.

Qualified Privilege encourages surgeon participation in self-audit by strictly protecting the confidentiality of information gained in the audit. It prevents third parties, such as legal representatives or courts from using surgical reports for purposes that could potentially be to the detriment of the surgeon in question.

Surgeons can now take advantage of knowing that the information they liberally divulge will be utilised exclusively for its designed professional development purpose and nothing else.

Qualified Privilege means that entering data into SurgicalPerformance will not leave surgeons vulnerable.