Frequently Asked Questions

1. What is RAD?
  • RAD, which is the acronym for Regional Anaesthesia Database is an App that collects medical and/or clinical data for the purpose of patient safety to foster improvement in quality of care provided to patients.
  • The application is solely developed to address areas such as group governance to ensure the highest quality care and best outcomes for the patients.
2. Who are the users of RAD?
  • The main users of RAD are Eligible Practitioners and Anaesthetists.
3. What is the background for RAD?
  • Measuring and reporting outcomes from routine practice have effectively proven to improve quality and safe medicinal practice by inducing systemic data analysis.
  • It forms an essential component of evidence-based practice using which, every medical practitioner can strive to provide quality health service.
  • Medical practitioners in their busy practice find it hard to not only collect and store data, but also to analyze it and compare with benchmarks to improve practice.
4. What are the benefits of RAD?
  • he RAD is aimed to provide specialist anaesthetists and Pain management teams with
  • Ability to collect data/gather information from large number of patients close to the point of care with improved data integrity and reduced burden; including complete peri-operative care data along with patient related outcomes through a meaningful, seamless and consistent data entry system.
  • A national/international database registry that is accessible and user-friendly with quality management program
  • Tools to obtain benchmark information with reference to quality outcomes
  • Ability to generate customizable report for individual practitioner or institution
  • Improved data analytics for cognitive reasoning and behavioural studies.
5. What are the responsibilities of users?
  • The user needs to capture all the blocks performed by all anaesthesiologists 24/7 as incomplete block entries create selection bias.
  • Data should be entered at the time & point of care in theatre
  • Follow-up is needed on all patients with systematic postoperative follow-up and assessment for potential complications
  • Proactively monitoring outcomes will likely improve the patient safety and this app provides the system to benchmark and improve the quality and safety of routine clinical care. Hence the integrity and completeness of entered input data should be carefully monitored and maintained.
6. What type of data is collected?
  • ollowing data is collected as part of RAD App:
  • Hospital identifier, patient’s age, weight, gender, block status, date and time of operation
  • Preop details such as operation type and specialty, medical co-morbidities (e.g. diabetes), ASA physical status, emergency, availability of basic monitoring, resuscitation equipment and Lipid Rescue
  • Block information such as purpose, location, type, nerve identification details, patient status during block, local anaesthetic dosage, Acute complications, Technical Problems, and technologies used to perform the block.
  • Recovery information such as paint score at awake, after 30 minutes and discharge delayed, Paru Total Opioid Use and dosage
  • Follow-up details after first 24 hours and subsequent
  • Feedback information such as patient satisfaction scores and other notes
7. Would this cause any inconvenience to the patient?
  • NO. No practitioner will compromise patient safety for data entry. Priority always remains in patient care and data entry can be done at the earliest time.
8. Is Patient consent required for RAD App?
  • RAD aims to capture every patient who received peripheral nerve block (PNB), thus reducing a selection bias. There is no intervention being investigated because this App is a registry of routine clinical practice.
  • This App advocates quality assurance initiatives measuring outcomes from routine practice.
  • This is an unbinded observational cohort database and is NOT A RESEARCH activity. Every patient has the right to know what happens with that information and about security of cloud storage of sensitive information.
  • “Opt-out” consent can be used which has far better patient acceptance and recruitment. Medusys can help you to develop one such consent.
  • Always, speak to your local institutional ethics committee
9. What are the different types of patient identifiers which are used in the app?
  • The project does not collect any detailed information that directly identifies the patient. For example, we do not collect date of birth, phone number or address of the patient.
  • However, a unique identification number is randomly generated for each record and together hospital identifier, hospital staff can re-identify the patient and perform follow-up.
  • The hospital identifier can also be used to access the medical record so as to confirm outcomes and for data quality control
10. What steps are taken to protect patient identifiers and other health information (PHI)?
  • Protected information is only accessible for registrants to the online interface with unique username and password.
  • The online interface logs out automatically if the computer/mobile screen is left unattended for 20 minutes.
  • A UIN (Unique Identification Number) is created for every patient which is system generated random number for security and subsequently used through all queries thereby neutralizing the patient identification.
  • Individuals with login access to the App and online interface will have access to the reports.
  • All sensitive and PHI which could potentially identify a patient is encrypted for transfer from the computer terminal to a remote secure server
  • Patient Name or any patient identifier is not displayed in any of the queries or reports.
11. What are the safeguards of data in this app?
  • Patients’ information is stored in a de-identified manner only re-identifiable to each site that input the data for patient follow-up at the specific site.
  • Non identifiable data is stored in a secure remote server with password protected access to the on-line data base (with the exception of re-identifiable patient number that is only re-identifiable at the site where data was entered for terms of follow up only).
  • All sensitive data that could potentially re-identify the anaesthetist, the hospital or the patient (e.g hospital record number, age, height, weight) are encrypted for transfer from the data entry terminal to the server.
12. Is the App login password protected?
  • To login to the registry you need your email address and a password.
13. What are the best practices incorporated for Data Protection In Transit and At Rest for RAD App?
  • We have incorporated several effective security measures that offer robust data protection across endpoints and networks to protect data in both states.
  • One of the most effective data protection methods for both data in transit and data at rest is data encryption.
  • Implemented robust network security controls to help protect data in transit. Network security solutions like firewalls and network access control have been implemented to help secure the networks used to transmit data against malware attacks or intrusions.
  • We don’t rely on reactive security to protect data. Instead, use proactive security measures that identify at-risk data and implement effective data protection for data in transit and at rest.
  • Other data protection solutions are implemented with policies that enable user prompting, blocking, or automatic encryption for sensitive data in transit, such as when files are attached to an email message or moved to cloud storage, removable drives, or transferred elsewhere.
14. How is the RAD App deployed and what the security measures taken?
  • The encrypted database is protected behind a firewall and is not accessible to anyone outside the firewall.
  • Session gets expired after 20 minutes of inactivity, requiring a re-login from the browser.
  • ‘Oauth token’ based authorization for mobile access ensures restriction of any sort of unauthorized access to the system.
16. Are project governance and datasets validation measures deployed?
  • A memorandum of understanding has been generated explaining collaborators’ responsibilities. Subscription Details, Terms & Conditions Document, Privacy Policy Document, End User License Agreement (EULA) are clearly displayed at the time of user registration.
  • Individual data collectors and users of the App will be required to acknowledge its content during their initial log-on process.
  • The users have ownership of their dataset and will be able to remove or upload the datasets to cloud server as per their requirements.
17. What are the Organizational safeguards put in place to make it Hipaa Compliant
  • Several Administrative, Technical and Physical Safeguards are incorporated to ensure security and integrity of datasets, both at rest and in transit.
  • Security awareness training has been implemented so employees are trained and reminded of policies and procedures relating to software updates
  • Computer log in monitoring, password updates and other key security measures are implemented
  • Contingency planning, adequate preparation, policies and procedures are in place in order to respond to an emergency if there is a fire, vandalism, or other natural disaster
  • Physical safeguards, facility access controls are implemented to protect the location and devices during development and deployment.
  • Sufficient practices are implemented to allow access to only those people who need access to do their jobs.