AMS Injury Record
What is the Athlete Management System?
The Athlete Management System (AMS) is a web-based platform designed to capture information from a variety of sources including athlete training and competition data, health related information and administrative records among other things. The AMS allows professionals that work with an athlete or a team to have real-time access to the relevant information related to their role to support performance-related decision making.
Clinical record keeping | Streamlining handovers | Injury surveillance
The AMS can be accessed over any internet connection throughout Australia and the world. This feature is particularly useful for clinicians involved in athlete care. Many athletes have more than one clinician involved in their care, particularly as they transition from their daily training environment into a camp or competition environment. The AMS allows clinical information to be shared in a way that was difficult beforehand, streamlining the process of handover between clinicians. The AMS also meets medicolegal requirements for clinical record keeping, allowing clinicians to record clinical notes in the AMS only, without the need to duplicate these in other systems.
As well as maintaining up-to-date clinical information, the AMS Injury Record Form provides the opportunity to systematically collect population health surveillance data and allow injury trends within our high performance (HP) system to be monitored over time. Injury surveillance is the first step towards understanding injury trends and provides the foundation for developing targeted and effective injury prevention strategies. As clinicians, we understand the benefit that injury or illness prevention can have on performance – a fit and healthy athlete is an athlete that can train to their fullest capacity, thus increasing their chances of successful competition performance!
In order to ensure quality care during athlete transition periods (continuity of care via appropriate information handover) and to ensure effective injury prevention systems, we need to ensure we are collecting quality information/data. Recently, the AIS published an updated version of the AMS Data Dictionary (The definitions and use of the injury record within the Athlete Management System). This is an extensive document outlining why, what and how we collect information regarding athletes’ injuries. The key messages from the Data Dictionary will be covered in this education module, though it is worthwhile for all clinicians to be familiar with all aspects of the document. It is a great reference to refer to if you have any questions as you use the AMS Injury Record.
The AMS Data Dictionary
The definitions and use of the injury record within the Athlete Management System.
The Basics - Getting Started
A web browser and an internet connection is all you need to access the AMS.
Chrome & Firefox are the recommended browsers.
Please note: Internet Explorer or Safari should not be used.
Click the button to head on over to the AMS Website on your computer or tabular device.
Terms and Conditions
The AMS Client Terms and Conditions will appear on first login. Please ensure you read these carefully before agreeing and entering the system.
Forms for Clinical Records
This brief lesson explains how to determine and select the correct form to record your notes.
Determining which form to use
Once an athlete has been selected, the next step is to determine which form to use - an Injury Record form or Maintenance Rx and Handovers form.
If a clinical assessment is undertaken and an athlete is determined to have a medically recognised injury, then an Injury Record form should be used to record clinical notes.
The definition of an injury as outlined in the AMS Data Dictionary is:
“[t]issue damage or other derangement of normal physical function due to participation in sports, resulting from rapid or repetitive transfer of kinetic energy that results in an athlete receiving medical attention.”
If no medically recognised injury is present, recording of the athlete encounter can be made in the Maintenance Rx and Handovers form.
It is worth noting that the above definition relates to injuries resulting from an exposure to sports training or competition. Injuries occurring as a result of other activities should still be entered into the AMS.
For Non-Sport Related Injuries
Though all injuries an athlete sustains are recorded in the AMS, sports injury analysis that aims to quantify the risk associated with sport specific participation should exclude recorded injuries that are not related to sport specific exposure (e.g. car crash). Injuries that have occurred due to a non-sports related activity are captured within the "Injury activity" section of the injury record form.
A comprehensive understanding of the definitions used in relation to injury in the Australian High Performance Sport sector can be found in the AMS Data Dictionary.
Summary of the injury definitions as described in the AMS Data Dictionary (The definitions and use of the AMS injury record, V2.1, 2020)
Injury Records - Creating a New Injury Record
Below you will find information on how to do the following within an injury record form:
• Complete the injury details
• Record consultation notes
• Save the injury record form
Creating a New Injury Record
When an athlete presents for an assessment of a new injury, a new injury record needs to be created. Select "+ New Injury Record" from the Injury Management section of the left sidebar.
Collecting Injury Data
Date of Injury
The initial field requests the date that the injury occurred. This is distinct from the date of the first clinical assessment, which might often occur days after the injury occurred.
The date of injury may be obvious in the event of an acute injury but will require the clinician's/athlete's discretion if the injury was insidious in nature.
Injury Classification - New vs Recurrent
This field determines if the injury is a new type of injury (new diagnosis) or a recurrent injury (same diagnosis as a previous injury).
A recurrent injury should only be selected if the injuries have exactly the same diagnosis and are on the same side (left/right) as the previous injury.
An exacerbation of an injury is also considered a recurrent injury.
If a recurrent injury is selected you will be shown a list of the athlete's injury history and requested to select which historical injury this is a recurrence of.
Selecting the historical injury will not "re-open" the old injury record. You will still need to complete a separate injury record form for this recurrence, though it will mean some fields of the form are pre-filled (e.g. diagnosis).
The injury onset relates to the manner of which the injury commenced. The options include:
Selecting a Diagnosis
The injury section contains an interactive body chart which prompts the clinician to click on the body site where the injury has occurred. Following this a series of selection boxes appear that then prompt a more specified diagnosis using the OSICS injury code.
It is important that the most precise diagnosis be selected. This step can be completed (or adjusted) at any stage in the process of completing the Injury Record. Many clinicians choose to make (or adjust) their diagnosis once a thorough history and physical examination have taken place.
The diagnosis can be altered at any stage of an athlete's care, even on subsequent consultations.
Further information regarding the diagnosis can be added to the extra notes textbox to clarify or supplement the OSICS diagnosis.
Diagnostic code update
On 24 March 2020 the Orchard Sports Injury and Illness Classification System (OSIICS-13.1) was published as the successive iteration of the OSICS-10.1. The OSIICS-13.1 will be incorporated into the AMS injury form in the coming months. This will not change the data entry processes listed below, but will provide updated injury and illness diagnostic codes and terminology.
Same Body Site
If there are two injury diagnoses at the same body site, the most severe of the diagnoses should be selected first.
For example, if our athlete with the MCL injury also sustained an abrasion to the knee during the incident which required medical attention, the grade 2 MCL strain would be considered the most severe and selected first, as the primary injury, followed by the abrasion.
The rubbish bin icon to the side of the diagnosis can be used to delete the selected diagnosis and the arrows move the diagnosis up or down with regards to the severity of the injury.
Different Body Sites
If there are multiple injuries that occur at different sites, they should be recorded within different injury record forms as they are considered two separate injuries.
For example, if the athlete injured their MCL and sustained a concussion during the same incident, two separate Injury Record forms should be completed and notes relating to each injury be documented separately in the appropriate record.
Though time consuming, currently recording different injuries in separate forms is required to ensure accurate injury surveillance data (a true understanding of the burden of injuries).
The AMS team are working on a way to make this process more efficient - watch this space!
The concussion should not be recorded within this injury record for the knee injury, rather in it's own new injury record specifically related to the concussion. This allows for the recovery time of the concussion to be documented separately to the knee injury.
Time saving options a clinician might use in this example include writing notes regarding both the MCL and the concussion in the treatment table for the MCL injury, then copying and pasting these notes into the seperate concussion injury record OR writing "refer to MCL injury" as the treatment notes for the concussion injury.
Injuries Requiring Surgery
Any surgery performed for injury management should also be recorded within the injury record form. It is important that the injury is entered first prior to entering the surgical code as a second diagnosis code.
After selecting a surgical OSICS code, a brief section titled Surgery details will appear. This section collects the date that the surgery was performed under Surgery date, and allows for free-text related to the surgery to be entered under Surgery details. The date of the surgery is important to capture as it allows the duration of the injury to be separated according to time prior to surgery and time post-surgery to be distinguished.
Significant Medical History
An injury should be identified as "significant" only if it will affect the maximal training capacity of this athlete for the duration of this athlete's career. This can be changed at a later date, if for example it is only evident after months of rehabilitation that this athlete may not be able to return to certain activities in order for them to continue to train, compete and perform without the repercussions of this injury negatively impacting performance.
Prognosis - Expected Return to Full Training
This is a required field, meaning you will not be able to save your injury record until this has been completed. It is an estimate, using clinical reasoning, as to when you anticipate this athlete will be ready to resume full training.
If no training restrictions are suggested (or the athlete has not had to reduce their training as a result of this injury), then this can be dated as the same date that the injury occurred.
This is another field that can be changed as further details regarding an athlete's injury are made available (responsiveness to treatment, etc).
Other Injury Information
Further information is often requested, but the specifics of the information required will depend on which sport the athlete participates in. Information might be related to the mechanism by which the injury occurred, the setting during which they injury occurred (i.e. training vs competition), the time during training/competition at which the injury occurred, what equipment was being used, which discipline within a sport, etc.
Questions relating to these fields should be directed back to the sport, as these will be determined by each National Sporting Organisation.
Non-sport related injury
Injuries that occur due to or during non-sport related activities should be flagged in the Injury Activity section of the injury record form. This allows these injuries to be excluded from any analysis that aims to quantify the risk associated with sport specific participation.
Recording Consultation Notes
This section of the injury form provides the clinician with the opportunity to document their consultation notes from their session with the athlete. All clinical notes that relate to the injury are kept here.
It is important that the treatment date is reflective of the date the consultation took place - not the date the note was written, which is recorded automatically.
See section below.
Notes taken to document the clinical history or subjective examination are recorded here.
Notes regarding the objective or physical examination undertaken are recorded here.
This where notes outlining the treatment that the patient received during this consultation are documented.
This area is to document general plans and impressions made by the clinician during the consultation.
See section below.
This section auto-fills with the name of the clinician logged into the AMS.
T stands for "treated by", indicating the discipline of clinician entering the notes.
P = physiotherapist
M = doctor
This relates to the athlete’s training status; that is, the impact of this injury on the athlete’s ability to participate in their primary mode of training. Further clarification of what this means is detailed shortly.
Full training and competition
Unrestricted participation in the primary mode of training or competition at an equivalent level to pre-injury/illness when at full capacity, as planned by coaching staff if the athlete was uninjured/healthy.
Modified training and competition
Any reduction from pre-injury/illness full capacity or restriction to an athlete’s participation in training or competition, as planned by coaching staff, that is based on medical restriction and relates only to the primary mode of training.
No training or competition
The athlete is completely unable to participate in the primary mode of training or competition based on medical advice.
Notes entered in the Shared Notes section of the table are visible to selected and approved members of the high performance team, which may include coaches, Performance Directors and other performance support staff (S&C, sports and movement scientists, psychologists, soft tissue therapists, dietitians, etc). This section is intended to be used as a platform to communicate information regarding an athlete’s rehabilitation status to the key members of the high performance team, without sharing the confidential components of the treatment record.
Examples of information shared in these notes might be an update of prognosis, information regarding return to sport planning, current activity restrictions or training guidelines, recommendations made for athletes to connect with other performance support practitioners, etc.
Shared notes are an important means to sharing information regarding the athlete and their rehabilitation plans.
Please make sure you enter a summary of information you should share with coaches, S&C coaches and any other performance support team member.
If you are unsure who will have visibility of your Shared Notes, please contact your sport's administrator.
Primary Mode of Training
Examples outlining primary modes of training are listed below.