Perioperative registries in resource-limited settings: The way forward for Pakistan

Area of Science:

• Health Services Research
• Surgical Quality Improvement
• Global Health

Background:

• Perioperative registries enhance surgical quality through benchmarking, reporting, and risk prediction.
• These registries are established in high-income nations but are underutilized in lower- and middle-income countries (LMICs).
• Significant barriers impede the implementation and sustainability of perioperative registries in LMICs.

Purpose of the Study:

• To identify and analyze the key challenges hindering the establishment and effective functioning of perioperative registries in LMICs.
• To propose potential strategies and solutions to overcome these identified challenges.
• To advocate for the wider adoption and integration of perioperative registries in LMICs to improve surgical outcomes.

Main Methods:

• A review of existing literature and case studies on perioperative registries in various economic settings.
• Analysis of common challenges including data entry, technological infrastructure, personnel expertise, and data quality.
• Exploration of adaptable solutions such as leveraging existing electronic medical records, telemedicine, and standardized coding systems.

Main Results:

• Limited electronic medical records and inadequate IT infrastructure pose significant data entry challenges.
• Lack of expertise and resources for software development and maintenance requires external support.
• Poor medical record quality and high patient attrition rates complicate case ascertainment and outcome assessment.
• The need for standardized clinical terminology and coding for data interoperability is critical.

Conclusions:

• Overcoming challenges in LMICs requires tailored strategies for data management, technological integration, and resource allocation.
• Telemedicine can aid in post-discharge outcome assessment, addressing high loss-to-follow-up rates.
• Adapting existing disease and procedural codes offers a sustainable and cost-effective approach to achieving data standardization and interoperability for perioperative registries.