Real-Time Reporting of Complications in Hospitalized Surgical Patients by Surgical Team Members Using a Smartphone Application

Abstract

Background

The surgical morbidity and mortality (M&M) conference is a vital part of a resident's surgical education, but methods to collect and store M&M data are often rudimentary and unreliable. The authors propose a Health Insurance Portability and Accountability Act (HIPAA)–compliant, electronic health record (EHR)–connected application and database to report and store complication data.

Methods

The app is linked to the patient's EHR, and as a result, basic data on each surgical case—including diagnosis, surgery type, and surgeon—are automatically uploaded to the app. In addition, all data are stored in a secure SQL database—with communications between the app and the database end-to-end encrypted for HIPAA compliance. The full surgical team has access to the app, democratizing complications reporting and allowing for reporting in both the inpatient and outpatient settings. This complication information can then be automatically pulled from the app with a premade presentation for the M&M conference. The data can also be accessed by a Power BI dashboard, allowing for easy quality improvement analyses.

Results

When implemented, the app improved data collection for the M&M conference while providing a database for institutional quality improvement use. The authors also identified additional utility of the app, including ensuring appropriate revenue capture. The general appearance of the app and the dashboard can be found in the article.

Conclusion

The app developed in this project significantly improves on more common methods for M&M conference complication reporting—transforming M&M data into a valuable resource for resident education and quality improvement.