MPOG 2019 Annual Retreat
Sachin Kheterpal
October 18, 2019
Disclosures
• I have no personal financial, consulting, contractual relationships with any vendor
• I am PI or co-PI on funded projects
– NIH re: T32 training program
– BCBSM re: anesthesiology QI
– Merck re: Neuromuscular Blockade Monitoring and Reversal
– Becton Dickinson re: Medication Error Epidemiology and costs
– Apple re: trajectories of health detected by digital phenotyping
Thanks
• Kevin Tremper Nirav Shah Katie Buehler
• Mark Dehring Tory Lacca John Vandervest
• Aleda Thompson Genevieve Bell Chris Heiden
• Shelley Housey Anik Sinha Brooke Szymanski
• Jay Jeong Robert Coleman Jenny Mace
• Jeremy Jared Mike Burns Nick Douville
• Tomas Medina Allison Janda Meridith Bailey
• Mike Mathis Douglas Colquhoun David Clark
• Nicole Pescatore Michelle Romanowski Ben Cloyd
• MPOG chairs, PIs , ACQRs, quality champions, and software developers
• All the clinicians, IT staff, and administrators out there
How are we doing?
• Infrastructure / administrative
• Technical
• Research
• Quality improvement
MPOG national impact
• 12 Million patient records extracted, mapped, de-identified, and available for research
and performance improvement
– 23 health systems, 40+ hospitals, 18 states, 2 countries, 6 EHR vendors
– Comprehensive intraoperative record
– 24 BILLION vital signs for these patients
– Laboratory values, Mortality, Discharge ICD9/10, Preop ICD
– Pockets of surgical registry and claims
• More than 3500 providers receiving monthly email feedback
– 20+ performance measures across 30 hospitals
– Going beyond data to collaboration
– Maintenance of certification
• Papers ranging from health services research to informatics methodology
Infrastructure / administrative
• Organizational resiliency
– MPOG contracts established at all contributing centers (thank you)
– DUA, BAA, etc in place to enable innovation
– Robust executive board with real oversight
– Distributed leadership and involvement
• Engagement at each center
– Clear points of contact for technical, research, and QI
• Financial diversity
– Industry grants
– MOCA Part IV
– BCBSM
– NIH & other foundation grants
– MPOG contract revenues
How I feel many days at the office
Technical
• Exciting upgrade features in 2019
• Types of data in production
– PACU / floor data now coming in from sites
– Surgical registry integration penetration
– CMS national data (thank you Yale)
– Blinded record index to allow 3
rd
party data integration (death, costs, etc)
– PROSPER wearables
• Tools
– DATADirect 2.0
– Application suite with brand new case viewer
Research
• Publications (and rejections) in JAMA
• Publications committee reviewers distributed across the country
• NIH and ABA awards
– Anesthesia dosing in the elderly
– Teamwork and collaboration in the OR
– Is MOCA associated with clinical practice improvement
• First IMPACT (Pragmatic trials) NIH submission attempt by Vanderbilt (INTRAOP-OX)
• Dozens of manuscripts in accepted, in review, revision, or manuscript writing phase
• Diverse topics with many different faculty at each contributing member
Research Progress in 2019
• Accepted / Published
– MPOG methods
– Association of hypotension & AKI stratified by baseline patient risk
– Clinical & operational impact of concurrent surgery
• Under review / revision at major journals
– Epidemiology and cost of medication errors CPT machine learning
– Association of sugammadex and pulmonary complications
– Clinical management of pyloric stenosis in US
– Blood pressure artifact management algorithm One lung vent outcomes
• Analysis complete, manuscript in preparation
– Blood utilization patterns EOS 2017 Part I
– Handoffs and outcomes Hypotension epidemiology
– Perioperative AKI GWAS
QI updates
• Impact beyond active MPOG sites
• New implementation toolkits
• Maintenance of Certification is buzzing
• Measure advancements
– Maturing old measures
– Casting a wider net on focus for new measures
• National impact for > 3500 providers each month
Self-assessment of last years goals
• Data foundation: “B+” (up from a B)
– Expand data types to include PACU and floor data
– Machine learning for CPT prediction
• Analytics: “A-” (up from a B+)
– True high performance computing statistics environment available
– DATADirect 2.0 in beta release shortly
• Impact: “B+” (steady)
– Distribute research infrastructure across departments
– QI, research, grant submissions all more diverse
• Collaboration: “A” (up from a B)
– More engaged with diverse specialities, disciplines, industry
– More faculty involved at each site
What is our culture?
• Collaboration
• Scientific transparency and rigor
• Technical excellence
• Patient focus
• Humility
How did we get that culture?
• This mysterious mustached man
• Kevin K Tremper PhD, MD
• Founder of MPOG
• Chair @ UM since 1991
• Stepping down so he can have more
coffee and hang out at MPOG HQ
more often
• Thank you for your continued
mentorship and leadership for the
medical field
Thank you
