On- and Offline Documentation of Spine Procedures: Spine Tango

Abstract

The mainstays of patient care throughout the ages used to be intuition, psychology and charisma. In this environment, which was characterized by trust on the part of the patients and society and self-confidence and dedication to the cause on the part of the clinician, considerable advances in medical therapy were made. Only a few players in the medical arena made initiatives for a systematic assessment of what was done and what the result of those treatments were. Among them was Florence Nightingale, a nurse, who applied statistical methods for analyzing preventable deaths in the British military during the Crimean War as early as 1854. Ernest Codman, a US physician and the father of what is today considered as outcomes management in patient care, became famous in the early 1900s for his “end results system” which stated that every patient needed to be followed up to assess the benefits and complications of the received treatment. Finally, Maurice E. Müller, cofounder of AO/ASIF (Arbeitsgemeinschaft Osteosynthese/Association for the Study of Internal Fixation), published his concept of a multisite trauma registry with centralized database for assessment of surgeon performance, efficacy of surgical techniques, and postmarket surveillance of implants in 1963 (Müller ME, Allgöwer M, Willenegger H, Die Gemeinschaftserhebung der Arbeitsgemeinschaft für Osteosynthesefragen, Arch klin Chir 304:808–817, 1963).