by: Matthew DiPaola, MD
My friend and Senior Editor at iMedical Apps, Felasfa Wodajo is admittedly more organized than I am. He already has an electronic database of all of his surgical cases. Mine is on paper. Felasfa built his using Filemaker. I, on the other hand, have been meaning to go electronic for a while.
To be honest though, I have not been looking forward to building a database on my own. Recently, however, I found Surgichart, and it opened my eyes to the possibilities out there. In fact, I may not even have to build anything on my own, since it looks like they’ve done it for me.
Most surgeons are familiar with the concept of the case log. During residency we logged our procedures in the ACGME system to prove that we were compiling a representative breadth of procedures in our particular field. Unless it’s changed since 2008 though, the user interface of this system was painful enough to make the whole experience electronically logging cases an unpalatable thought. So when I heard that Surgichart had created an app to log and organize surgical cases, I was eager to review it.
Surgichart is a web based app developed by surgeons that is meant to log and share case files in a HIPPA compliant manner- a laudable goal. Originally billed to serve spine surgeons, the app accommodates case records for surgeons in any field. It provides a nice interface to log relevant surgical case data, images, outcomes, and notes. It also allows the user to share this information with colleagues.
Overall, I found the app useful. The main menu screen displays icons for tracking your charts, colleagues, delegates (people that you assign editing privileges) and favorites. The interface is clean and easy to navigate.
Entering “my charts” takes you to a bookshelf appearing space which stores your charts. Click the “+” icon to add a new chart. I like that you can organize the charts by planned cases or recent days. Entering the chart takes you to an area that allows you to edit the various “tabs” within the chart.
The “tabs” at the bottom of the page include charts, op data, notes, images and videos. The picture below shows the “op data” interface. It includes most of the basic data one would want to describe a given case. I don’t find the “time of incision” menu option useful, though. “Surgery duration” might be a more meaningful data point.
The program allows the user to compile notes on various aspects of the case: history, physical exam etc. Notably missing was a section to free-hand “intra op” notes. I feel that this would be best suited for the “op data” section. I like to make relevant notes about things that I would like to improve upon or techniques that I found worked particularly well (or not so well) intra-operatively so that I can refer back to them in the future. I found myself having to slot those comments into the “notes” section where they did not seem to fit well. In addition I wanted to ensure that this section remained private.
There are further tabs at the bottom of the page to add videos and images. I did not try out the video upload section, although I did add images in my charts. In this section you can upload case images such as X-rays and MRI’s and easily label them with a title as well as designate them as “pre op” intra op” or “post op” from a pull down menu.
For me this process was time consuming. I had to save electronic images from my EMR to my hard drive, then upload them to the program. I found myself wishing that I could simply copy and paste the pictures directly into the app. If the developers could do this, it would be a BIG improvement.
Overall, the app did most of what I wanted it to do. I did not quite understand how the charts were labeled. My new chart numbers were given #’s in the 1800’s and then were non continuous. Is this the total number in the system? It would make more sense to have them labeled per surgeon so that he knows how many cases he had logged in total. The main barrier to adoption of this app will probably be time. You have to be motivated to take the extra time to input the cases.
Costs and plans:
- Surgichart is available for free as a strictly web based service. The iPhone and iPad apps come with a 30 day free trial and then require a monthly or yearly subscription fee. I found the pricing confusing.
- There are three pricing tiers: surgeons subscribe for $4.99 monthly or $49.99 per year, health industry professionals subscribe for $9.99 monthly or $99.99 per year, and health professionals subscribe for $.99 monthly or $9.99 per year.
- It is unclear from my trial run or the description in the App Store whether there are differences in functionality between the user levels. If there are the company should make this clear.
- Web based
- Easy to use
- Made a database that I didn’t have to make from scratch
- Sharing capability
- Cut and paste image upload
- Confusing pricing
- Expanded intra op notes section