ABNS POST is an integrated IT platform, 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 relevant to ABNS evaluation and certification processes. Those processes include the ABNS Oral examination, 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 Power Point format for the oral exam (thus evolving a previously multi-step process to a consolidated procedure).
Past ABNS clinical data systems (e.g., NeuroLog) 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 more uniform and complete data submission, along with the development of true national benchmarks for performance and experience. These factors will ensure more 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. Note that some text fields are required, and others are optional. In either case, text fields 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.
Analyses of imaging data are critical to understanding clinical outcomes and decision-making in neurological surgery. As such, review of imaging data has now has become a key component of the new (spring 2017) 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 and/or post-operative) in POST.
The data submission tool is broken down into 4 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 case and edit existing ones. This section is being modified to allow for generation of Power Point presentations to support the ABNS Oral exam.
Please make sure to complete practice details in My Practice section in ABNS POST before you begin entering your cases. Be sure to save prior to proceeding. This section specifies the site of service list which 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 & Medications
- Neurological Diagnoses
- Surgical Management: Description of procedure(s), Surgical adjunct used, Surgical role, and CPT code entry
- Clinical Summary: History & Presentation and Physical examination
- Imaging & Testing: Include up to 8 images: preoperative, intraoperative, and/or postoperative
- Non-Surgical Management
- Surgical Outcomes: Objectives of surgery, Immediately post-operative outcomes(during hospital stay), Intermediate post-operative outcomes (discharge to 3 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 apply this rule of thumb to the submission:
Please 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 specific 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 circumstance, the presence of mild, diet-controlled DM is not likely of great significance to clinical management or outcomes and this data can be excluded.