ABNS POST is an integrated IT platform that is designed to advance the ABNS’ mission of promoting safe, effective and appropriate neurosurgical care. POST allows for the submission, analysis and presentation of clinical data from practice, along with other information that is relevant to the ABNS’ evaluation and certification processes. Those processes include the ABNS oral examination, CC/MOC and focused practice.
The primary function of POST is to support the ABNS oral exam. ABNS candidates can use POST to collect case data for ABNS review in addition to preparing selected case presentations in PowerPoint format for the oral exam (evolving a previously multistep process to a consolidated procedure).
Past ABNS clinical data systems primarily utilized text fields which often led to variable data submission and occasionally missing data elements. POST’s design allows for the collection of discrete data elements describing patient variables, diagnoses, procedures, clinical decision-making and outcomes. This format allows for uniform and complete data submission, along with the development of true national benchmarks for performance and experience. These factors ensure objective and equitable reviews of presented information and mitigate the potential that candidates will have to resubmit data due to missing elements.
In addition to discrete data fields, the ABNS has retained several text field options, should ABNS candidates or other POST users wish to augment the required data with other information relevant to clinical decision-making. Some text fields are required and others are optional. Text fields also provide candidates and other POST users a forum to provide information they feel would be useful to the review process.
Highlights of POST:
The addition of imaging data is perhaps the most significant enhancement to ABNS case review processes.
Analysis of imaging data are critical to understanding clinical outcomes and decision-making in neurological surgery. Review of imaging data is a key component of the oral exam format. When imaging is a standard part of the clinical decision-making process, candidates will be required to submit between 1-8 case images (pre-, intra or post-operative) in POST.
The data submission tool is broken down into four main sections:
- Dashboard: Project overview, system updates and links to important supplementary information
- Case logs: A listing of all your case logs in the system. If you have only one case log, it opens it.
- My practice: Includes individual physician profile and practice details.
- My Cases: The POST clinical data entry system allows for adding new cases and edit existing ones. This section is being modified to allow for generation of PowerPoint presentations to support the ABNS oral exam.
Please make sure to complete practice details in the ‘My Practice’ section in ABNS POST before you begin entering your cases. Remember to save before proceeding. This section specifies the site of service list that must be completed before selecting a site of service in an individual case.
The outline below identifies the information needed to enter a complete case.
- Overview:Patient and site of service
- Medical History and Medications
- Neurological Diagnoses
- Surgical Management:Description of procedure(s), surgical adjunct used, surgical role and CPT code entry
- Clinical Summary:History and presentation and physical examination
- Imaging and Testing:Include up to eight images: preoperative, intraoperative or postoperative
- Non-surgical Management
- Surgical Outcomes:Objectives of surgery, immediately post-operative outcomes (during hospital stay), intermediate post-operative outcomes (discharge to three months) and late outcomes (3-12 months)
The amount of data input required will be variable between submitted cases—this feature is intentional.
In sections that allow for entry of variable amounts of information (e.g., medical history, imaging data), it is suggested to include the minimum (i.e. essential) information you would require to explain your clinical decision-making and justify the clinical outcome(s) to another clinical colleague regarding the specific case being described. See examples below.
Elderly patient presenting with large subdural hematoma after fall and undergoes emergent craniotomy, subsequently experiences a post-operative hemorrhage requiring return to OR. In this instance, medical comorbidities and likely medications that increase risk of bleeding complications (e.g. aspirin, Plavix) are relevant to both decision-making and clinical outcomes and should be included in the submission.
Young patient undergoes routine microdiscectomy lumbar HNP, has routine post-operative course and experiences excellent outcomes. In this instance, the presence of mild, diet-controlled DM is not likely of great significance to clinical management or outcomes and this data can be excluded.