ASPIRE Collaborative Meeting Slides 7.17.20

ASPIRE

Collaborative

Meeting

July 17th, 2020

Agenda

Housekeeping

• All participants will be muted on entry

• Unmute yourself to participate but remember to re-mute

yourself when complete

• We encourage attendees to use video

• To obtain CME credit, please make sure your Zoom display

name is correct (first and last name)

• Feel free to use Zoom chat during the meeting - we will

monitor

Zoom Helpful Hints

Unmute / Mute (redline)

Start / Stop Video (red line)

Tip: Make sure your camera is on

Zoom Chat

Rename display

Post Meeting Information

•On our website:

o Recorded keynotes

o Presentation slides (except performance review)

o Meeting summary and notes

•CME information will be sent to all participants via e-

mail after the meeting

MPOG

Business

• Upcoming Events

• New Dashboard – Kate Buehler

• AKI Toolkit – Kate Buehler

• Mortality data in ASPIRE

• Research projects using ASPIRE data

Upcoming Events

MPOG Annual Retreat

October 2

2020

Virtual

Welcome!

Henry Ford Allegiance

Eric Davies, MD

Gary Loyd, MD

ACQR: Jessica Wren, BSN, RN

Henry Ford Wyandotte

Jimmy Boutin, MD

Daniel Mekasha, MD

ACQR: Jessica Wren, BSN, RN

Henry Ford Macomb

Merajuddin Khan, MD

ACQR: Jessica Wren, BSN, RN

2020 P4P Changes (pending BCBSM approval)

• Adjusting the attendance credits to 3 – 4 / 4 meetings

(March meeting canceled.)

• Site based meetings can be virtual depending on your site’s

current policies

• Cohort 5 and Trinity upload dates will be adjusted due to

COVID-19

• Performance measure changes – TBD, need more data

Dashboard 2.0

• Available for beta testing now: Quality Champions & ACQRs only

• Provider emails still link to existing dashboard displaying individual

provider performance

• Existing dashboard still available- will retire old dashboard by MPOG

retreat in October

• Submit feedback to coordinating center: support@zendesk.mpog.org

Departmental Dashboard: Selected Measures

Navigation: Filters

Measure Summary

*Based on site Location Mapping

Main ASC Ortho Center

Case List

AKI Toolkit

Acute Kidney Injury

Toolkit Released!

Includes six tools:

• Overview/Pathophysiology

• Recommendations for Adult

Surgical Patients

• Avoiding Kidney Injury:

Pediatrics

• Avoiding Kidney Injury:

Obstetrics

• Avoiding Kidney Injury:

Cardiac Surgery

• Reference Guide (one-pager)

https://mpog.org/akitoolkit/

Mortality Data

Last year…

• We explained the BRI (Blinded Record

Index), a tool for matching patients

across different entities, and you

implemented it.

• At each site, we create a hashed code

using PHI stored locally. Ensure that it is

computationally infeasible to reverse

code.

• Planned to link data with Michigan

Death Index and also to help determine

readmission rates.

Early match results with MDI day mortality results

Total Michigan MPOG Patients in 2019

465,285

Total MDI records in 2019

97,438

Exact and Highly Probably Matches between MPOG and MDI

16,502

MPOG

MDI

Preliminary 2019 all cause mortality using MDI data

5.5%

4.7%

4.3%

3.5%

3.4%

2.9%

2.7%

2.6%

2.5%

2.4%

2.3%

2.2%

2.1%

2.0%

1.1%

1.0%

0.0% 0.0% 0.0%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

Michigan Institutions

MDI High-Scoring Possible Match Rate

Sample cases

• OPEN REDUCTION INTERNAL FIXATION OF MULTIPLE RIGHT RIB

FRACTURES , AND RIGHT CHEST TUBE PLACEMENT

• RIGHT PHACOEMULSIFICATION WITH INTRAOCULAR LENS

• TRANSPLANT LIVER

• EGD W/ ANES

• EXPLORATORY LAPAROTOMY, ABDOMINAL WASHOUT, POSSIBLE

BOWEL RESECTION, POSSIBLE WOUND VACUUM, POSSIBLE OSTOMY

• MIDLINE POSTERIOR LUMBAR SPINAL FUSION WITH STEALTH

Research Projects of

Interest

Does Anesthesia Quality Improvement Participation Lead

to Incremental Savings in a Surgical Quality Collaborative

Population?

• Aim: Leverage the payment data captured by the Michigan

Value Collaborative (MVC) to examine the difference between

costs before and after ASPIRE quality improvement

participation, and the difference between costs between

institutions that do and do not participate in ASPIRE.

• Hypothesis: Participation in ASPIRE is associated with

reduced cost for high volume procedures included in the MVC

registry.

• Primary Investigator: Allison Janda, MD

Results

• For all payers across all procedure types, we found significantly greater

reduction in post-discharge and total episode payments for procedures

performed in ASPIRE hospitals compared to non-ASPIRE control hospitals

• Trends in specific components of total episode payments -- index,

readmission, and professional fee payments -- were not significantly different

between the 2 groups, but all trended lower in the ASPIRE hospitals.

Payment Type Difference-in-differences estimate ($) p-value Standard error

Index Episode -346.05 0.1103 216.69

Post Discharge -354.30 0.0023 116.44

Readmission 45.57 0.5803 82.41

Professional Fee -54.22 0.1918 41.54

Total Episode -718.62 0.0234 316.94

FAER-ABA Research in Education Grant

Seeks to evaluate the value of primary certification and the Maintenance of Certification in

Anesthesiology™ program (MOCA®) to clinicians and the public, including assessment of how

certification is related to clinical performance and novel means to analyze and utilize data.

ASPIRE now is involved in the first two

projects sponsored by the FAER-ABA

Research in Education Grant:

• The first, led by Ben Cloyd MD at the University of

Michigan, is evaluating the association between

MOCA participation and selected ASPIRE metrics.

• Preparing to be presented at PCRC

• The second, led by Julie Huffmyer MD at the

University of Virginia, will evaluate whether an

association exists between MOCA Minute

performance and selected ASPIRE metrics, and

will begin in 2021.

Thank you

Keynote Speaker – Gary Loyd, MD, MMM

• Director, Perioperative Surgical

Home

• Director, Quality Programs in

Anesthesia

• MPOG PI and IT Champion – HF

Allegiance

Thank you

Keynote Speaker – Matt Wixson, MD

• Associate Chair, Diversity

• Assistant Director, Medical

Student Education

Thank you