Synoptic Reporting for Surgery Shows Impact in Canada

Thanks to centralized, government-issued mandates for health IT initiatives, Canada has always been a trailblazer for capturing discrete data in healthcare. Whether its pathology, radiology, or (now) surgery, Canada has led the way in conforming to standards and best practices for physician reporting. All of these initiatives serve a larger plan that is twofold:

1) Seeing the risks and trends in proper care for cancer and other high risk diseases
2) Understanding the demographic trends in diseases based on age, gender, and geographic location

Recently,, an online resource initiative that Canadian Partnership Against Cancer (CPAC) created for connecting physicians, citizens, and other interested parties to the data being collected, has published some of their findings. Not only does this data give an exciting and revealing look into the state of cancer in the country — across multiple provinces — but it also shows why synoptic reporting is the tool needed for capturing, analyzing, and reporting on such information.

An overview of the surgical synoptic reporting project can be found on this page, which details the various organ sites for which CPAC created templates designed to capture structured data. In full disclosure, mTuitive — which has been a leader in synoptic reporting in healthcare for over 15 years — takes part in this endeavor by supplying all of Nova Scotia with their synoptic surgical reporting needs. In fact, much of the provincial data displayed in the research (see below) comes directly from surgeons using mTuitive OpNote at their facilities. But this page and the subsequent data being shown reveals why synoptic reporting is such a powerful tool in the hands of physicians.

Without a mandate from governments, health organizations, or accreditation bodies, surgeons in the United States have been slow to adopt the structured approach of synoptic reporting. It makes sense — most of them were trained in dictation and transcription, most are merely concerned with getting the report done as quickly as possible, to ensure no lawsuit and proper reimbursement. Many of these factors are of course eliminated in the single-payer national structure that Canada (and, in fact, the vast majority of industrial countries) uses. But while there are small pockets of users here and there in the U.S. (including OpNote customers at ASCs and Vascular facilities), synoptic reporting is not a priority for surgeons. This is a real shame, based on the information that can be easily and efficiently pulled from the databases created by a structured data approach.

Synoptic reporting, as has been written elsewhere, is simply an organized way of presenting and entering in information; instead of the freeflowing dictation, there are specific fields with specific places for responses. Some of those responses can be limited (multiple choice, single choice select, etc.) to ensure that the same vocabulary is used to describe the same situation across patients. This builds a universal lexicon that allows apples to be compared to apples, as it were, and makes abstraction a near instantaneous process. That's also because, if done correctly, electronic synoptic reports are also structured data capture tools — that means that each piece of data entered is a searchable field that can be compared to other searchable fields to learn more about the procedure, best outcomes, or the disease facing the patient.

To truly understand the power of structured data capture, especially when discussing cancer treatment, CPAC offers up their vision for an empowered approach to retrieving this data and how to best use it for future treatments. In the presentation "A Path to Standardize Surgical Oncology Care," readers can easily see the power of this vital information. Provinces can compare their cases, can see best practices in battling specific cancers, and can also understand how each physician is faring in his or her work compared to national and provincial averages. This allows facilities to know which physicians need to conform to better standards, which may need re-credentialing or further help, or even something as simply as boasting about the best outcomes for patients with specific cancer diagnoses.

Furthermore, CPAC also offers up why surgical synoptic reporting is so impactful in understanding cancer and its surgical treatment. In "Improving patient care in Canada with Pan-Canadian Synoptic Surgery Reporting Standards," there are multiple examples of the differing outcomes between provinces for essentially the same treatment on the same diseases. So what are the major differences? Only by capturing all of this information in a structured way can physicians and researchers find the sources of variation and modify treatment approaches to ensure the best possible outcome for every patient struggling with this horrific disease.

mTuitive has long been a proselytizer for synoptic reporting. Not just because it's our business, but because of the power it has to improve population health. Unfortunately, that power goes to waste when people continue using outdated manual processes. So much information, great insights into the best way to combat diseases that ravage so many people every year, is lost to unstructured paragraphs that have no universal lexicon or set of standards on what to report. CPAC is truly leading the way in capturing this information and using it to better the lives of Canadian patients everywhere. It's high time the rest of the world caught on, too.