A surgeon's journey into the world of IT: the medwebtools.com database

The need for quality data at Worcester Hospital became apparent in the early 2000s when monthly reporting of “surgical wound infections” was introduced by the hospital administration as a quality-of-care indicator in surgical wards. Nursing staff were tasked to capture the data, and an inordinate monthly number of “surgical wound infections” were reported directly to hospital management, who entered this into a provincial health information system. Closer scrutiny revealed a system designed without the guidance of surgeons that erroneously collected data on patients with soft tissue infection and diabetic foot sepsis and not as intended only those with surgical site infections. The lesson learnt was poor design means garbage in, and hence you will get garbage out. Clinicians should take the lead in monitoring their specialty-specific outcomes, by starting with a well-defined question and work backwards to enable database design.1,2