MPOG 2020 Virtual Annual Retreat
Sachin Kheterpal
October 2, 2020
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
• Genevieve Bell Chris Heiden Michelle Romanowski
• Shelley Vaughn 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 Ben Cloyd Chelsea McKinney
• George Mashour
• MPOG chairs, PIs , ACQRs, quality champions, and software developers
• All the clinicians, IT staff, and administrators out there
Anesthesiologists making us proud
Lee Fleisher CMO, CMS James Grant, CMO, BCBSM
Thank you to everyone
• COVID sucks
• Faculty and staff redeployed during COVID surges across country
• Anesthesiology, nursing, IT, and administrative pride
• Praying to not need your service again
MPOG and COVID
• Remote work and collaboration using
Webex / Zoom is our default way
• Many of our staff have flex hours, work
from home schedules
• Building relationships and trust
through shared mission, not shared
location is our culture
• Wish we could laugh and cry together
What have we done, and where are we headed?
An uncertain but productive year at MPOG coordinating center & sites
• 2 weddings, 1 engagement, 4 babies
• Stable and maturing staff and faculty group
• Welcome new contributing sites
– Dartmouth-Hitchcock University of Chicago
– UC, San Francisco MD Anderson Cancer Center
– Henry Ford Allegiance, Macomb, Wyandotte
• > 20 states, more than 50 hospitals/health systems, 14.5M anesthetic records
• More than 30 sites converted to latest MPOG integration software (“Import Manager”)
• MPOG was made for this…
Progress
• Financial and governance stability
– Sustained support from BCBSM, research funders, MPOG sites
– Diverse forms of value to our members (QI, research, MOCA, hospital leadership)
– MPOG executive board with turnover, fresh perspectives, and support
• Research operations and redundancy
– Publications committee moderators
– Data extract analysts
– Team effort to structure proposal development, review, data extract, and analysis
– Reliable NIH (R, K) and Foundation funding for MPOG sites using MPOG data
– Strong, diverse research proposals from many different sites
Progress
• Quality improvement
– Vibrant specialty subcommittees Revised dashboard
– Measure review Focusing on the right measures
– Advancing the culture of ASPIRE
• IT and Administrative
– Sophistication of tools
– Robust product planning process
– Predictable upgrade and product release schedule
– More consistent and independent onboarding process
– Staff depth and specialization
– Tools that help research and QI (Blinded record index, data direct)
Data integrations to enable QI and research
• Surgical registry
– More by Dr. Michael Mathis
– National (local linking at each site): STS-Thoracic, STS-Cardiac, ACS-NSQIP
– State: MSQC (a version of NSQIP), MTQIP (trauma) in progress
• Payor
– National: CMS (thank you Yale and Dr. Schonberger)
– State: MVC (thank you BCBSM)
• Blinded record index
– In production across all of MPOG
– Enables centralized linking to any dataset without sharing identifiers
– Mortality, patient flow between hospitals
Where do we need to go?
• Do more with the data we have
– It’s a QI and academic “goldmine”
• Enhance the research and QI integration
– The “learning health system”
Do more with the data we have
• Cleaning up our “phenotypes” and “collations”
– Hiding ones that aren’t ready for broad consumption - Emphasizing ones that are ready
• Use quality metrics as exposures and outcomes
– EXTREMELY well curated data (by 4,500 people every month)
• Use DataDirect to define 90% of inclusion/exclusion criteria
• Focus on research and QI topics leveraging recent, high quality data
– Intraop record PACU Discharge ICD10 Lab values
– Reliable intraop observations
Do more with the data we have
• Use MPOG data as a foundation for prospective, funded work
– Pragmatic clinical trials
– Prospective observational cohort studies
• Take advantage of merged dataset that extend beyond EHR
• Create research and QI “themes” across centers that build upon one another
Enhance QI and research integration
“Learning Health Systems”
Assemble
Real-World Data
Interpret
Results
Analyze
Data
Hypothesis
Knowledge to Practice
Develop &
Pilot Toolkit
Iterate,
Disseminate
Data to Knowledge
Publish
Qualitative
Analysis
Quantitative
Analysis
• All of our work is clinically
ground
• However, do the missions
“feed” each other enough?
– Research benefits from QI
data quality obsession
– QI benefits from clinically
meaningful research
• How often and with what
mechanism do we share
needs across QI and
Research committees?
Summary
• It’s been a strange, productive, sad, and inspiring year
• Amazing how much progress MPOG sites and Coordinating Center have made
• MPOG is the foundation for pragmatic anesthesiology research and QI
• We need to leverage the last decade of data and collaboration investment
Thank you
