Kern Singh, MD, founded the Minimally Invasive Spine Study Group (Non-Profit 501c3) in February to promote quality-driven research in the field. Dr. Singh is a co-founder of the Minimally Invasive Spine Institute at Rush in Chicago and serves on the study group's executive board alongside his colleagues Frank Phillips, MD, co-founder of the Minimally Invasive Spine Institute at Rush, and New York City-based Hospital for Special Surgery's Sheeraz Qureshi, MD.
"The aim of the group is to become a national and international organization for those who want to participate," says Dr. Singh. "Membership isn't limited to surgeons; industry, payers and hospitals are also welcome. All parties that have a stake in spine patient outcomes and those who drive financial and clinical decision-making are valuable to the group."
Dr. Singh began collecting data twelve years ago and has collected approximately 300 pre-, intra- and postoperative surgical variables. Dr. Singh has around 4,000 patients in the registry totaling around 1.2 million data points. The data points include quality outcomes, clinical differences between implants, satisfaction and surgical costs.
"Over the past three or four years, the idea of registries has received a lot of traction and more surgeons are collecting data and trying to participate," says Dr. Singh. "The problem with adding more surgeons is we want to keep the data meaningful; if new members don't maintain 95 percent compliance with our data points, all of a sudden the database has errors and corruptions."
Although Dr. Singh has received more than 100 emails inquiring about participation, only select centers will meet the criteria initially in order to maintain accuracy of the registry. Participants are required to have a someone onsite dedicated to managing data entry in order to collect all variables required.
Study group members will be able to conduct prospective studies using the database to answer questions about spine procedures. The database is located on a server from the National Institutes of Health customized to minimally invasive spine.
"As we progress in the evolving healthcare market, payers are looking for data justifying the payment for medical procedures and analyzing costs to establish the true cost of procedures like a MIS fusion," says Dr. Singh. "We can look at the quality adjusted life year for those procedures and see which interventions may be costing too much. The site of care also plays a role in cost and more surgeons could have the opportunity to do these surgeries outpatient."
The data can also gather complication risks and rates over a large dataset. Surgeons will be more accurately able to predict outcomes and return-to-work time for individual patients. The increased data collection can also show demonstrate procedures are more effective and lead to more uniformity in the profession.
"If we look at joint replacements or heart bypass surgery, a patient will get the same procedure whether they walk into a physician's office in Montana, Chicago or New York. In spine surgery, that's not yet the case," says Dr. Singh. "The spine patient can walk into three different offices and receive three different recommendations for treatment. Why shouldn't spine outcomes be more reproducible? Now we have the data to get us there."
Cost containment initiatives, bundled payments and global payments also drive spine surgeons and specialists to find the high quality, low cost treatments.
The Minimally Invasive Spine Surgery Study Group will have an informational session at the International Society for the Advancement of Spine Surgery annual meeting and Dr. Singh hopes the group's registry will grow over the next six months as new members are added.