MPOG 2023 Retreat Welcome

Sachin Kheterpal MD MBA

Executive Director, MPOG

Congratulations to Michael Avidan, MBBCh, Elected to NAM !!

October 9

, 2023: Elected to the National Academy of Medicine

(formerly “Institute of Medicine”)

One of only 100 new members chosen each year

“For his international leadership in clinical anesthesiology research. He

has designed and led large-scale, pragmatic clinical trials that have

elucidated the role of clinical monitoring in the prevention of

intraoperative awareness and delirium as well as the relationship of

general anesthesia to neurocognitive outcomes of surgery.“

Dr. Seymour and Rose T. Brown Professor of Anesthesiology

Head of the Department of Anesthesiology at Washington University,

St. Louis

Thanks

• Henrietta Addo * Nicole Barrios Kate Buehler

• Mike Burns David Clark Chelsea Cloyd

• Robert Coleman Douglas Colquhoun Mark Dehring

• Nick Douville Nicole Eyrich Anthony Edelman*

• Chris Heiden Allison Janda Jeremy Jared

• Jay Jeong Tory Lacca Tiffany Malenfant

• George Mashour Mike Mathis Diane O’Dell

• Rebecca Pantis* Ronnie Riggar Michelle Romanowski

• Sandy Rozek Robert Schonberger* Nirav Shah

• Calvin Shenk Anik Sinha Frances Guida Smiatacz*

• Kevin Tremper Sushma Vallamkonda John Vandervest

• Shelley Vaughn Meridith Wade Andrew Zittleman

• MPOG chairs, PIs , ACQRs, quality champions, and software developers

• All the clinicians, IT staff, researchers, QI specialists, and administrators out there

• Departments, BCBSM, PCORI, NIH, Industry funders for your financial belief in the mission

*New to MPOG Coordinating Center since 2022

A lifetime ago, but feels like yesterday Aug 23, 2008

Bunch of anesthesiologists and

surgeons got together in Ann Arbor to

discuss sharing anesthesiology and

surgery data to enable multicenter

research

Cleveland Clinic

Johns Hopkins

Massachusetts General Hospital

Oregon Health & Sciences University

University of Alabama, Birmingham

University of California, SF

University of Colorado

University of Michigan

University of Pennsylvania

University of Utah

Vanderbilt University

Washington University, St Louis

A brief history in MPOG time

• 2004 – 2008: Papers using single center MPOG data

• Fall 2008: Initial meeting bringing together anesthesiologists & surgeons to share data

• 2010: Begin integrating data across centers for MPOG research

• 2011: Six sites with data integrated: UM, UColorado, OHSU, Columbia, Mass Gen, UVermont

• 2012: First “MPOG” paper (epidural hematoma, but didn’t use MPOG data infrastructure)

• 2013: First MPOG paper using MPOG data (difficult mask), first “QI report” mock up

• 2014: BCBSM supports launch of ASPIRE, as a part of surgical registry

• 2015: First QI feedback emails to clinicians, quality committee, QCDR rollout

• 2017: Enhanced observational study, Maintenance of Certification Part IV integration

• 2018: Centralized analysis server rollout

• 2019: NIH, ABA, IMPACT grant awards

• 2020: Hmm..what happened then?

• 2021: PCORI funds $30M THRIVE trial

• 2022: QI subcommittees humming, Research fellowship, NIH grants to multiple centers

MPOG is an effort of passion for everyone here…

Hitting our stride in the new hybrid world

• Many personal challenges for faculty and staff over last year

• Welcome new contributing sites

• MPOG in 25 states, multiple countries

• International presence

– American University Beirut active

– Multiple Canadian hospitals onboarding

– Continued European engagement

Johns Hopkins University Nebraska Medicine

Temple University UMass Memorial

University of Alabama at Birmingham University of Maryland

University of Texas Southwestern

Broader?

More hospitals?

More missions?

ICU and Chronic pain?

Last year we asked: Where do we go from here?

More clinical impact?

Closer to the patient?

Higher research impact?

More data sources?

Broader Deeper

More hospitals

More countries

Education mission

We did a little bit of both

Clinical trial engagement

Inpatient acute pain data

Mature surgical registries

Broader Deeper

Trajectories of Recovery after Intravenous propofol versus inhaled VolatilE anesthesia

Feasibility Trial Goals and Results

✔

Enroll enough patients (300 across University of Michigan & Washington University [St Louis])

Goal: 10% of patients who are approached consent

Actual: 53% of patients approached were consented

✔

Administer the assigned anesthetic successfully

Goal: 80% compliance with each treatment allocation

Actual: 95% for TIVA, 99% for INVA

✔

Complete data collection

Goal: 90% complete data for primary outcomes of recovery and awareness

Actual: 93% for Quality of Recovery-15 and 99% for Modified Brice

✔

Launch Full Scale

Goal: Engage 12 MPOG hospitals as enrollment sites

Actual: 21 hospitals in process; 3 hospitals enrolling already (WashU, Umichigan, Yale)

THRIVE-ing around the country – 12,480 patients to go!

Deep quality improvement impact in dozens of departments worldwide

Meaningful MOCA and continuing education

Sustainability toolkit impacting care on a daily basis

What’s coming up?

IMPACT multicenter pragmatic clinical trial awardee

THRIVE full scale phase randomization across 20+ hospitals, 12,500 patients

Mature standardized data file

QI reporting tool advances

Measure review, refinement, and retirement

Precision feedback trial

Phenotype improvements and additions

Data pipeline, processing, and analysis re-architecture (multi-year effort)

Alpha development of floor, ICU, inpatient medication data beyond EPIC extract

Education initiatives

Expanding machine learning and workflow automation in everyday MPOG work