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Iowa Head and Neck Protocols Mission Statement and History

last modified on: Mon, 11/20/2023 - 14:27

The Iowa Head and Neck Protocols were initially designed to provide clinically relevant information to health care providers. The "Protocols" were published in book form in 2000 with this specific goal established (see preface to book below). The transfer of the book to the Internet in 2003 exposed this information to a larger audience, including patients.  In 2009 the adaptation of the "Protocols" to a wiki format markedly extended the potential to vividly present (with photos and videos) more information to a larger audience.  Since the adaptation to a wiki format, daily updates are now performed to the Iowa Head and Neck Protocols by health care providers at the University of Iowa under the supervision of the Iowa Protocols Review Committee (IPRC). This committee is comprised of members of the University of Iowa Otolaryngology Department including the clinic administrator. Conversion to the Drupal format occurred in the summer of 2017 to improve the presentation of the Iowa Head and Neck Protocols in broadening their accessibility beyond desktop computers to mobile devices.

Support for the Iowa Head and Neck Protocols comes from institutional grants and donations listed in the navigation panel List of Donors. The Department of Otolaryngology and the University of Iowa wish to acknowledge the support of those who share our goal in improving the care of patients we serve. The University of Iowa appreciates that supporting benefactors recognize the University of Iowa's need for autonomy in the development of the content of the Iowa Head and Neck Protocols.

Preface [to published hard copy version (book form) 2000]

The Iowa Head and Neck Protocols organizes diagnostic and management preferences in an accessible manner. The protocols are constructed in outline form to provide a brief and directed approach to diseases of the head and neck. The protocols should be considered helpful guidelines reflecting biases within a single institution. It is important to recognize that there are viable alternative approaches to patient care that are not presented. The protocols are not designed to serve the purposes of a surgical atlas or didactic text. The Iowa Head and Neck Protocols are designed to bridge the gap between procedural concepts and their implementation.

These protocols were initiated in 1989 to clarify the contributors' approach to new surgical procedures such as microvascular free tissue transfer, arytenoid adduction and extra-oral osseointegration. The surgical protocols were then expanded to include more basic procedures targeted for residents (to improve their understanding of surgical approaches), for nurses (to prepare instrumentation for surgical cases) and for anesthesiologists (to plan for patient positioning, drug administration and airway management). Beginning in 1992, the protocols were more formally assembled as a teaching manuscript and updated yearly for distribution at the annual Iowa Head and Neck Cancer and Reconstructive Surgery Course.

In the course of its yearly revisions, the Iowa Head and Neck Protocols expanded to include non-surgical patient care protocols for practicing physicians and nurses. The multi-faceted management of patients with diseases of the head and neck mandated the inclusion of protocols directed to other specialties including Speech Pathology and Dentistry.

Consistent with its intent to simplify patient care by providing useful information in a readily accessible format, American Medical Association's Current Procedural Terminology codes (CPT codes) are offered for each of the surgical procedures described. The surgical procedure codes are listed as they are employed by clinicians at the University of Iowa. Coding should reflect the procedures preformed or the care provided. Each physician practices medicine in a unique way based on training and experience. The CPT codes that are provided reflect our best effort to select the code(s) descriptive of the procedure(s). Additional CPT codes may be useful when coding complex, new or uncommon procedures. No attempt was made to link coding with reimbursement and no individual insurance carrier preferences were considered. On a yearly basis CPT codes are modified. The CPT codes provided in this text reflect the 1999 version.

Comprehensive lists of instruments are provided for each surgical procedure. We anticipate that these lists will be useful for both nurses and physicians when establishing a new practice and in preparing for the introduction of new surgical procedures. The list of contributing authors includes many individuals who participated in the preparation of earlier versions of the manuscript. Because each protocol has evolved gradually through multiple revisions with multiple authors, the contributing authors are not identified with individual protocols. As a result, the listing of a clinician as a contributing author should not be interpreted to mean that he or she agrees with all of the biases presented.

The evolving nature of the art of Head and Neck Surgery requires constant reappraisal and revision of guidelines. We anticipate that the Iowa Head and Neck Protocols will continue to be revised yearly with updates distributed through the internet as well as through manuscript and CD-ROM format.

CPT five-digit codes, nomenclature, and other data are copyright 1998 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS Restrictions Apply to Government Use.

Approval for inclusion of CPT codes (Current Procedural Terminology) in the 2000 version of the Iowa Head and Neck Protocols was obtained through the Singular Publishing Group from the AMA.  The CPT codes transferred from that book to the new Iowa Head and Neck Protocols on the web (https://iowaheadneckprotocols.oto.uiowa.edu/display/protocols/Home) have now been removed.  Yearly updates to the CPT codes are available at several sites on the internet and may be readily accessed through search engines employing terms such as “CPT coding”.

                                                                    IPRC (Iowa Protocols Review Committee) December 28, 2015

See also: Forewards written for the book form; "Evaluating Health Information on the Internet" from the National Library of Medicine: Evaluating Health Information | NNLM