Characterizing physician directory data quality: variation by specialty, state, and insurer.

BACKGROUND: As U.S. legislators are urged to combat ghost networks in behavioral health and address the provider data quality issue, it becomes important to better characterize the variation in data quality of provider directories to understand root causes and devise solutions. Therefore, this manuscript examines consistency of address, phone number, and specialty information for physician entries from 5 national health plan provider directories by insurer, physician specialty, and state. METHODS: We included all physicians in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) found in ≥ 2 health insurer physician directories across 5 large national U.S. health insurers. We examined variation in consistency of address, phone number, and specialty information among physicians by insurer, physician specialty, and state. RESULTS: Of 634,914 unique physicians in the PECOS database, 449,282 were found in ≥ 2 directories and included in our sample. Across insurers, consistency of address information varied from 16.5 to 27.9%, consistency of phone number information varied from 16.0 to 27.4%, and consistency of specialty information varied from 64.2 to 68.0%. General practice, family medicine, plastic surgery, and dermatology physicians had the highest consistency of addresses (37-42%) and phone numbers (37-43%), whereas anesthesiology, nuclear medicine, radiology, and emergency medicine had the lowest consistency of addresses (11-21%) and phone numbers (9-14%) across health insurer directories. There was marked variation in consistency of address, phone number, and specialty information by state. CONCLUSIONS: In evaluating a large national sample of U.S. physicians, we found minimal variation in provider directory consistency by insurer, suggesting that this is a systemic problem that insurers have not solved, and considerable variation by physician specialty with higher quality data among more patient-facing specialties, suggesting that physicians may respond to incentives to improve data quality. These data highlight the importance of novel policy solutions that leverage technology targeting data quality to centralize provider directories so as not to not reinforce existing data quality issues or policy solutions to create national and state-level standards that target both insurers and physician groups to maximize quality of provider information.

Knowledge Engineering Framework for IoT Robotics Applied to Smart Healthcare and Emotional Well-Being.

Social companion robots are getting more attention to assist elderly people to stay independent at home and to decrease their social isolation. When developing solutions, one remaining challenge is to design the right applications that are usable by elderly people. For this purpose, co-creation methodologies involving multiple stakeholders and a multidisciplinary researcher team (e.g., elderly people, medical professionals, and computer scientists such as roboticists or IoT engineers) are designed within the ACCRA (Agile Co-Creation of Robots for Ageing) project. This paper will address this research question: How can Internet of Robotic Things (IoRT) technology and co-creation methodologies help to design emotional-based robotic applications? This is supported by the ACCRA project that develops advanced social robots to support active and healthy ageing, co-created by various stakeholders such as ageing people and physicians. We demonstra this with three robots, Buddy, ASTRO, and RoboHon, used for daily life, mobility, and conversation. The three robots understand and convey emotions in real-time using the Internet of Things and Artificial Intelligence technologies (e.g., knowledge-based reasoning).

Evaluation of the Three National Lesbian, Gay, Bisexual, Transgender, Queer, and Other Sexual and Gender Minority (LGBTQ+)-Competent Provider Directories in the United States.

Provider directories may serve as a bridge solution until lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) education becomes a requisite within standard medical education. The three national LGBTQ+-competent provider directories in the United States were evaluated. Two directories served the LGBTQ+ community while one served the gender minority community. All enumerated thousands of providers. One allowed provider-specific feedback. All provided searchable criteria (e.g., provider name, location, specialty, population identity, service type, payment types, gender identity, and languages spoken). By implementing these key features, existing and future directories could better provide equitable healthcare access for the LGBTQ+ population.

Fluctuations in the Number of Stores by Industry During the COVID-19 Pandemic Based on Japanese Phone Book Entries.

Currently in Japan, summaries of the number of bankruptcies due to the spread of COVID-19 can only be obtained from surveys conducted by a few research firms targeting particular companies. In this study, we used Japanese telephone directory data containing detailed information on the location and industrial category of stores/facilities nationwide in an effort to infer the influence of COVID-19 on businesses in Japan. We analyzed the temporal change in the number of stores before and after the COVID-19 outbreak. Among other findings, the analysis revealed that the number of travel agencies and facilities offering karaoke and other forms of entertainment declined significantly after the outbreak in some prefectures, with the largest declines in Ibaraki, Osaka, and Hyogo prefectures, and a relatively small decline in Tochigi prefecture. Among the stores and facilities categorized as restaurants and travel-related services, the decline was particularly significant in urban areas such as Tokyo and Osaka prefectures.

Distribution of the head and neck surgical oncology workforce in the United States.

BACKGROUND: The recent trends in education and geographic distribution of the head and neck surgery workforce have not been studied extensively. METHODS: We reviewed publicly available sources to locate all fellowship-trained head and neck surgeons and recent graduates. The number of surgeons in each state was compared against head and neck cancer incidence data from the Centers for Disease Control. RESULTS: The number of graduates increased annually by 1 per 100 000 000 people from 2011-2020. The average number of fellowship-trained surgeons per state was 10 (SD: 12). The average number of new head and neck cancer cases per surgeon was 247 (SD: 135). Ten states (20%) had cases >1 SD above the national average/surgeon, while 3 (6%) had cases >1 SD below the national average. CONCLUSION: Head and neck surgeons are located in most states, but not uniformly. Most states have approximately average density of surgeons; however, several states are outliers.

Provider directory accuracy and timely access to mammograms in California.

Provider directory accuracy and access to timely appointments are crucial determinants of health outcomes. However, to our knowledge, no studies have analyzed provider directory accuracies or network adequacy for mammograms, an important preventive service. We fill that gap using large-scale, random, and representative surveys of provider directories and timely access for all managed care plans in California for mammogram providers, obtained from the Department of Managed Health Care for 2018 and 2019 for commercial, ACA marketplace, and Medicaid plans with more than 33,000 observations. Directory inaccuracies ranged from a low of 23 percent to a high of 38 percent. Consumers were able to schedule appointments with specific providers within 15 days in between 59 percent to 73 percent of cases. Comparisons of accuracy and adequacy between the three markets (commercial, ACA, Medicaid) were inconsistent. Even with one of the nation's strictest and most well-resourced regulatory regimes for provider networks, our findings show substantial inaccuracies and inadequacies exist.

Demographics and distribution of australia's medical immigrant workforce.

Background: International medical graduates (IMGs) have made important contributions to Australian healthcare since colonization. Recent published data have documented source countries and characteristics of IMGs undertaking the examinations of the Australian Medical Council. However, information about those currently practicing in Australia is limited. Objective: To analyze a cross section of IMGs currently practicing in Australia to determine patterns of change in donor countries, other demographic characteristics, geographical locations, and their areas of specialization. Methods: A random sample of all practitioners on a national database was interrogated for their country of first medical qualification. Those who qualified outside Australia were then analyzed for demographic variables such as age, gender, country of origin, and years of graduation and immigration. Their practice locations were matched to the Australian Bureau of Statistics geographical framework, and their specialties compared with those of a random sample of graduates from Australian medical schools. Results: Over the approximately 60 years since those surveyed arrived in Australia, IMGs' countries/regions of origin have changed from mainly the UK and Ireland to Southern Asia, in line with demographic changes in Australia as a whole. Most arrived soon after graduation, and IMGs are twice IMGs as likely as local graduates to be working in a rural area of workforce shortage. Compared with local graduates, significantly more IMGs are working in general practice. Conclusions: IMGs currently practicing in Australia make up a substantial proportion of the workforce and are more likely than local graduates to provide health services in regional and remote areas.

Qualitative assessment of online information available on accredited head and neck surgery fellowship programs.

BACKGROUND: The present study aims to assess the quality and availability of online information about fellowships accredited by the American Head & Neck Society (AHNS). METHODS: AHNS directory pages and institutional web sites of 50 AHNS-accredited fellowships were identified. Web pages were scored using 20 standardized criteria including general information, application information, alumni, surgical training, research, and quality-of-life. RESULTS: Median scores for AHNS directory pages and institutional web sites were 11 (range: 7-14) and 10 (4-15), respectively. Faculty listings, contact information, program location, number of positions, and breadth of surgical exposure were the most commonly listed criteria. Less common criteria included didactic schedule, protected academic time, previous research projects, year of accreditation, work-life balance, fellow selection criteria, interview information, and salary. CONCLUSIONS: The AHNS directory and institutional web sites are most comprehensive in general program information and details about surgical training. Information about the application process, work-life balance, and research opportunities were less common.

Ransomware: Analysing the Impact on Windows Active Directory Domain Services.

Ransomware has become an increasingly popular type of malware across the past decade and continues to rise in popularity due to its high profitability. Organisations and enterprises have become prime targets for ransomware as they are more likely to succumb to ransom demands as part of operating expenses to counter the cost incurred from downtime. Despite the prevalence of ransomware as a threat towards organisations, there is very little information outlining how ransomware affects Windows Server environments, and particularly its proprietary domain services such as Active Directory. Hence, we aim to increase the cyber situational awareness of organisations and corporations that utilise these environments. Dynamic analysis was performed using three ransomware variants to uncover how crypto-ransomware affects Windows Server-specific services and processes. Our work outlines the practical investigation undertaken as WannaCry, TeslaCrypt, and Jigsaw were acquired and tested against several domain services. The findings showed that none of the three variants stopped the processes and decidedly left all domain services untouched. However, although the services remained operational, they became uniquely dysfunctional as ransomware encrypted the files pertaining to those services.

An Information Directory App InHouse Call for Streamlining Communication to Optimize Efficiency and Patient Care in a Hospital: Pilot Mixed Methods Design and Utility Study.

BACKGROUND: Communication failures disrupt physician workflow, lead to poor patient outcomes, and are associated with significant economic burden. To increase efficiency when contacting a team member in a hospital, we have designed an information directory app, InHouse Call. OBJECTIVE: This study aimed to describe the design of InHouse Call, objectively compare the usefulness of the app versus that of traditional methods (operator or pocket cards, etc), and determine its subjective usefulness through user surveys and a net promoter score (NPS). METHODS: This pilot study utilizing before-after trials was carried out at a tertiary academic hospital and involved 20 clinicians, including physiatrists, hospitalists, internal medicine and family medicine residents, and advanced practice providers/nurse practitioners/physician assistants. InHouse Call was designed to efficiently supply contact information to providers through a simple, user-friendly interface. The participants used InHouse Call in timed trials to contact a health care team member in the hospital via a telephone call. The effectiveness of InHouse Call in connecting the user with a contact in the hospital was measured through timed trials comparing the amount of time spent in attempting to make the connection using traditional methods versus the app. Usability was measured through exit surveys and NPS. RESULTS: The average time spent connecting to the correct contact using traditional methods was 59.5 seconds, compared to 13.8 seconds when using InHouse Call. The degree of variance when using traditional methods was 1544.2, compared to 19.7 with InHouse Call. A call made using the traditional methods deviated from the mean by 39.3 seconds, compared to 4.4 seconds when using InHouse Call. InHouse Call achieved an NPS of 95. CONCLUSIONS: InHouse Call significantly reduced the average amount of time spent connecting with the correct contact as well as the variability to complete the task, thus proving to be the superior method of communication for health care providers. The app garnered a high NPS and positive subjective feedback.

Inequitable impact of infection: social gradients in severe COVID-19 outcomes among all confirmed SARS-CoV-2 cases during the first pandemic wave in Sweden.

BACKGROUND: The backdrop of the ubiquitous social inequalities has increasingly come into foreground in research on the COVID-19 pandemic, but the lack of high-quality population-based studies limits our understanding of the inequitable outcomes of the disease. The present study seeks to estimate social gradients in COVID-19 hospitalisations, intensive care admissions and death by education, income and country of birth, while taking into account disparities in comorbidities. METHODS: We used a register-based retrospective open cohort design enrolling all 74 659 confirmed SARS-CoV-2-positive cases aged >25 years in Sweden during the first wave of the pandemic (until 14 September 2020). Information was retrieved from multiple registers and linked by the unique Swedish personal identity number concerning COVID-19 case identification; COVID-19 hospitalisations, intensive care admissions and death; comorbidities as measured by the Charlson Comorbidity Index; and sociodemographic information. Social gradients were estimated by the Relative Index of Inequality (RII) using Cox regression. RESULTS: Adjusted analyses showed significant social gradients in COVID-19 hospitalisation, intensive care admission, across education, income and country of birth, which were unaffected by adjustment for comorbidities. Education and country of birth gradients were stronger for hospitalisation and intensive care admissions but small to non-existent for death. In contrast, income gradients were consistent across all three COVID-19 outcomes. CONCLUSION: Social gradients in severe COVID-19 outcomes are widespread in Sweden, but appear to be unrelated to pre-existing health disparities. Inequitable outcomes of SARS-CoV-2 infection may therefore be at least partially avoidable and could rely on equitable management of confirmed COVID-19 cases.

Potemkin Protections: Assessing Provider Directory Accuracy and Timely Access for Four Specialties in California.

CONTEXT: The accuracy of provider directories and whether consumers can schedule timely appointments are crucial determinants of health access and outcomes. METHODS: We evaluated accuracy and timely access data obtained from the California Department of Managed Health Care, consisting of responses to large, random, representative surveys of primary care providers, cardiologists, endocrinologists, and gastroenterologists for 2018 and 2019 for all managed care plans in California. FINDINGS: Surveys were able to verify provider directory entries for the four specialties for 59% to 76% of listings or 78% to 88% of providers reached. We found that consumers were able to schedule urgent care appointments for 28% to 54% of listings or 44% to 72% of accurately listed providers. For general care appointments, the percentages ranged from 35% to 64% of listed providers or 51% to 87% of accurately listed providers. Differences across markets related to accuracy were generally small. Medi-Cal plans outperformed other markets with regard to timely access. Primary care consistently outperformed all other specialties. Timely access rates were higher for general appointments than for urgent care appointments. CONCLUSIONS: Our finding raise questions about the regulatory regime as well as consumer access and health outcomes.

Constructing a web-based health directory for adolescent men who have sex with men: Strategies for development and resource verification.

Online health directories are increasingly used to locate health services and community resources, providing contact and service information that assists users in identifying resources that may meet their health and wellness needs. However, service locations require additional vetting when directories plan to refer vulnerable populations. As a tool included as part of a trial of a mobile life skills intervention for cisgender adolescent men who have sex with men (AMSM; ages 13-18), we constructed and verified resources for an online resource directory focused on linking young people to LGBTQ+ friendly and affirming local health and community social services resources. We collected information for 2301 individual directory listings through database and internet searches. To ensure the listings aligned with the project's focus of supporting young sexual minority men, we developed multiple data verification assessments to ensure community appropriateness resulting in verification of 1833 resources suitable for inclusion in our locator tool at project launch (March 2018). We offer lessons learned and future directions for researchers and practitioners who may benefit from adapting our processes and strategies for building culturally-tailored resource directories for vulnerable populations.

Development of a Victorian Falls and Balance Service Directory.

OBJECTIVES: Falls and fall-related injuries amongst older people continue to be a long-term public health issue. Access to specialist services that target fall prevention has been shown to improve outcomes. This project aimed to develop an online directory of public outpatient and ambulatory falls and balance clinics and programs in Victoria. METHOD: Environmental scan of existing services and survey of service providers between January and August 2020. RESULTS: Forty-seven community-based and 53 hospital-based falls and balance services across metropolitan (46%) and regional (54%) Victoria registered. The majority of services were programs (70%) targeting exercise and/or education, as opposed to clinics (30%), which focus on diagnosis and developing management plans. Survey responses were collated to develop an online service directory: https://www.nari.net.au/victorian-falls-directory CONCLUSIONS: The Victorian Falls and Balance Service Directory provides a centralised and accessible reference for clinicians and community members regarding available outpatient and ambulatory services that target fall prevention.

List of priority congenital anomalies for surveillance under the Brazilian Information System on Live Births / Lista de anomalías congénitas prioritarias para la vigilancia bajo el Sistema de Información sobre Nacimientos Vivos en Brasil / Lista de anomalias congênitas prioritárias para vigilância no âmbito do Sistema de Informações sobre Nascidos Vivos do Brasil

Objective: To define the list of priority congenital anomalies for improving the registration in the Brazilian Live Birth Information System (Sinasc). Methods: Based on International Classification of Diseases, Tenth Revision (ICD-10), internation protocols and meetings with specialists, the list of priority anomalies was built considering two main criteria: being diagnosable at birth and having intervention available at different levels. The list was submitted for consideration by the Brazilian Society of Medical Genetics and Genomics. Results: The list comprised eight groups of congenital anomalies distributed according to the type of anomaly related, as well as the affect body part, all of which were related to some code of chapter XVII of ICD-10. Conclusion: The list of priority congenital anomalies for notification provides subsidies for improving registration at Sinasc.

Objetivo: Definir a lista de anomalias congênitas prioritárias para o aprimoramento do registro no Sistema de Informações sobre Nascidos Vivos (Sinasc). Métodos: A partir da Décima Revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10), protocolos internacionais e reuniões com especialistas, a lista de anomalias prioritárias foi construída considerando-se dois critérios principais: ser diagnosticável ao nascimento; e possuir intervenção disponível em diferentes níveis. A lista foi submetida a apreciação da Sociedade Brasileira de Genética Médica e Genômica. Resultados: Compuseram a lista oito grupos de anomalias distribuídos de acordo com o tipo de anomalia relacionada, bem como a parte do corpo afetada e sua correspondência ao código do capítulo XVII da CID-10. Conclusão: A lista de anomalias congênitas prioritárias para notificação fornece subsídios para o aprimoramento do registro no Sinasc.

Practical Advice for South Korean Medical Researchers Regarding Open-Access and Predatory Journals.

In recent decades, the volume of scholarly literature worldwide has increased significantly, and open-access publishing has become commonplace. These changes are even more dominant in South Korea. Comparing the periods of 1981-2000 and 2001-2020, the number of medical articles produced in Korea increased by 16.8 times on the Web of Science platform (13,223 to 222,771 papers). Before 1990, almost no open-access articles were produced in South Korea, but in the last 10 years open-access publications came to account for almost 40% of all South Korean publications on Web of Science. Along with the expansion of literature and the development of open-access publishing, predatory journals that seek profit without conducting quality assurance have appeared and undermined the academic corpus. In this rapidly changing environment, medical researchers have begun contemplating publication standards. In this article, recent trends in academic publishing are examined from international and South Korean perspectives, and the significance of open-access publishing and recent changes are discussed. Practical methods that can be used to select legitimate publishers, including open-access journals, and identify predatory journals are also discussed.

Lista de anomalias congênitas prioritárias para vigilância no âmbito do Sistema de Informações sobre Nascidos Vivos do Brasil / Lista de anomalías congénitas prioritarias para la vigilancia bajo el Sistema de Información sobre Nacidos Vivos en Brasil / List of priority congenital anomalies for surveillance under the Brazilian Live Birth Information System

Objetivo: Definir a lista de anomalias congênitas prioritárias para o aprimoramento do registro no Sistema de Informações sobre Nascidos Vivos (Sinasc). Métodos: A partir da Décima Revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10), protocolos internacionais e reuniões com especialistas, a lista de anomalias prioritárias foi construída considerando-se dois critérios principais: ser diagnosticável ao nascimento; e possuir intervenção disponível em diferentes níveis. A lista foi submetida a apreciação da Sociedade Brasileira de Genética Médica e Genômica. Resultados: Compuseram a lista oito grupos de anomalias congênitas distribuídos de acordo com o tipo de anomalia relacionada, bem como a parte do corpo afetada e sua correspondência ao código do capítulo XVII da CID-10. Conclusão: A lista de anomalias congênitas prioritárias para notificação fornece subsídios para o aprimoramento do registro no Sinasc.

Objetivo: Definir la lista de anomalías congénitas prioritarias para perfeccionar el registro en el Sistema de Información de Nacidos Vivos (Sinasc). Métodos: Con base en la Clasificación Internacional de Enfermedades, Décima Revisión (CIE-10), protocolos internacionales y reuniones con especialistas, la lista de anomalías prioritarias se construyó considerando dos criterios principales: ser diagnosticables al nacer y tener intervención disponible en diferentes niveles. La lista fue sometida a la consideración de la Sociedad Brasileña de Genética y Genómica Médica. Resultados: La lista comprendía ocho grupos de anomalías congénitas distribuidos según el tipo de anomalía relacionada, así como la parte del cuerpo afectada, todos ellos relacionados con algún código del capítulo XVII de la CIE-10. Conclusión: La lista de anomalías congénitas prioritarias para notificación proporciona subsidios para mejorar el registro en Sinasc.

Objective: To define the list of priority congenital anomalies for improving their recording on the Brazilian Live Birth Information System (Sinasc). Methods: Based on the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), international protocols and meetings with specialists, the list of priority anomalies was built considering two main criteria: being diagnosable at birth and having intervention available at different levels. The list was submitted for consideration by the Brazilian Medical Genetics and Genomics Society. Results: The list comprised eight groups of congenital anomalies distributed according to the type of related anomaly, as well as the affected part of the body and its corresponding code in ICD-10 Chapter XVII. Conclusion: The list of priority congenital anomalies for notification provides a basis for improving case recording on Sinasc.

A Web-Based Geolocated Directory of Crisis Pregnancy Centers (CPCs) in the United States: Description of CPC Map Methods and Design Features and Analysis of Baseline Data.

BACKGROUND: Crisis pregnancy centers (CPCs) are nonprofit organizations that aim to dissuade people considering abortion. The centers frequently advertise in misleading ways and provide inaccurate health information. CPCs in the United States are becoming more medicalized and gaining government funding and support. We created a CPC Map, a Web-based geolocated database of all CPCs currently operating in the United States, to help individuals seeking health services know which centers are CPCs and to facilitate academic research. OBJECTIVE: This study aimed to describe the methods used to develop and maintain the CPC Map and baseline findings regarding the number and distribution of CPCs in the United States. We also examined associations between direct state funding and the number of CPCs and relationships between the number of CPCs and state legislation proposed in 2018-2019 to ban all or most abortions. METHODS: In 2018, we used standard protocols to identify and verify the locations of and services offered by CPCs operating in the United States. The CPC Map was designed to be a publicly accessible, user-friendly searchable database that can be easily updated. We examined the number of CPCs and, using existing data, the ratios of women of reproductive age to CPCs and CPCs to abortion facilities nationally and by region, subregion, and state. We used unadjusted and adjusted negative binomial regression models to examine associations between direct state funding and the number of CPCs. We used unadjusted and adjusted logistic regression models to examine associations between the number of CPCs by state and legislation introduced in 2018-2019 to ban all or most abortions. Adjusted models controlled for the numbers of women of reproductive age and abortion facilities per state. RESULTS: We identified 2527 operating CPCs. Of these, 66.17% (1672/2527) offered limited medical services. Nationally, the ratio of women of reproductive age to CPCs was 29,304:1. The number of CPCs per abortion facility was 3.2. The South and Midwest had the greatest numbers of CPCs. The number of CPCs per state ranged from three (Rhode Island) to 203 (Texas). Direct funding was associated with a greater number of CPCs in unadjusted (coefficient: 0.87, 95% CI 0.51-1.22) and adjusted (coefficient: 0.45, 95% CI 0.33-0.57) analyses. The number of CPCs was associated with the state legislation introduced in 2018-2019 to ban all or most abortions in unadjusted (odds ratio [OR] 1.04, 95% CI 1.01-1.06) and adjusted analyses (OR 1.11, 95% CI 1.04-1.19). CONCLUSIONS: CPCs are located in every state and particularly prevalent in the South and Midwest. Distribution of CPCs in the United States is associated with state funding and extreme proposals to restrict abortion. Researchers should track CPCs over time and examine factors that influence their operations and impact on public health and policy.

Women in Neurosurgery (WIN): Barriers to Progress, World WIN Directory and the Way Forward.

Women in Neurosurgery (WIN) have come a long way and are making inroads in every neurosurgical subspecialty. There has been a worldwide increase in the number of female neurosurgeons both in the training and practice. Although this is a welcome trend, gender equality at work in terms of opportunities, promotions, and pay scales are yet to be attained. This is more apparent in the developing and underdeveloped nations. Barriers for a female neurosurgeon exist in every phase before entering residency, during training, and at workplace. In the neurosurgical specialty, only a few women are in chief academic and leadership positions, and this situation needs to improve. WIN should be motivated to pursue fellowships, sub-specialty training, research, and academic activities. Furthermore, men should come forward to mentor women, only then the gender debates will disappear and true excellence in neurosurgery can be attained. This article reviews the issues that are relevant in the present era focusing on the barriers faced by female neurosurgeons in the developing and underdeveloped countries and the possible solutions to achieve gender equality in neurosurgery. The authors also present the data from the World WIN Directory collected as a part of Asian Congress of Neurological Surgeons-WINS project 2019. These numbers are expected to grow as the WIN progress and add value to the neurosurgical community at large.