Digitization of Perioperative Surgical Flowsheets

Perioperative mortality rate (POMR) is a metric widely used to describe the quality of treatment in hospitals. Perioperative data, or data collected during surgery, can be used to calculate POMR and determine factors that lead to adverse surgical outcomes. Access to such data is essential for decreasing POMR and improving medical treatment. In low- and middle-income countries (LMICs), perioperative data is often manually recorded on paper flowsheets. While these flowsheets capture essential information, their non-digital format leads to difficulty in analysis of perioperative data, as aggregating data and observing trends is a time-consuming and tedious task. The goal of this project is to design a system to digitize the information contained in surgical flowsheets that have been in use for six years at the University Teaching Hospital of Kigali in Rwanda. To accomplish this goal, the research team has done the following: 1) Designed a wooden scanning structure, SARA (Scanning Apparatus for Remote Access), to capture flowsheet images in a standard format, 2) Developed a web application to upload images and securely transfer them to UVA for processing, 3) Developed image processing programs to digitize medication, blood pressure, heart rate and logistical data, and 4) Created a PostgreSQL database system to store the digitized flowsheet data. Additional testing and validation of this system is needed to evaluate the accuracy of each processing technique in the fully integrated system.