Virtual Participant Housekeeping

Zoom Webinar

• To ask a question

o Click the Q&A button at the bottom

of your screen.

o Type your question and hit send.

o We will be monitoring the

questions and will relay them

through the microphone onsite.

In-Person Participant

Housekeeping

● If you want to ask a question, please

go to the microphone in the front of

the room

● Wifi Information

○ Name: Warwickconf

○ Access Code: Warwick3

(Also see bottom of your agenda)

Please recycle your badges at end of

day

CME

Information

Last day to claim CME:

October 25, 2024, by 3pm Eastern

Organization Code: umich

Activity Code: 69031

See insert with agenda for in-person attendees or

the website for further instructions

Questions or Concerns?

Contact the activity coordinator(s) at

lacca@umich.edu, driggar@umich.edu or

smiatafr@umich.edu or visit

www.micme.medicine.umich.edu

MPOG 2024 Retreat Welcome

Sachin Kheterpal MD MBA

Executive Director, MPOG

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

• Sushma Vallamkonda John Vandervest Shelley Vaughn

• Meridith Wade Andrew Zittleman Rachel Stumpf*

• Mei Calabio* Kam Mirizzi * Xinyi Liu**

• Serena Wang ** Erik Lytle ** Rayann Yassine **

• Mahmoud Shehabeldin ** Chu An Tsai ** Ssu Ying Chen**

• Byungki Kim ** Peter Bow ** Alexis Stanczuk**

• Alexander Hoffman **

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

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

*New to MPOG Coordinating Center ** UM MAISE team members

A tragic note...

Matthew Arthur Carl Zapf, MD (1988-2024)

Vanderbilt University Anesthesiologist,

Researcher & MPOG member

Husband, Father, Friend, Son & Brother

Growing, Maturing, & Innovating

New health systems

Additional hospitals and sites within health systems

International reach

Coordinating center technical team integration

“In praise of maintenance”

Robust processes and policies to address new use cases

Passionate QI subcommittees

Education mission exploration

Technology “skunkworks” evolving

Broad research funding allows funded innovation

Evolving with our members and the healthcare industry

Healthcare consolidation, acquisition, and construction

QI dashboards scale up or down to meet leadership needs

Welcome: UNebraska, UHN Toronto, Mass Eye & Ear

> 280,000 cases added to registry each month

EHR, Performance, & Quality are international opportunities

Expanding data request scenarios, pace, variety

Easier data access & analysis

Support urgent clinical & QA needs

In praise of maintenance

Technology & process modernization & maintenance – MPOG 2.0

Prepared for modern cybersecurity attacks

Tightening onboarding/offboarding processes

Transitioning to Azure cloud hosted databases and processing

“Burst” resources consistent with data uploads & user needs

MPOG computing enclave resource expansion

Upgrading home-grown productivity tools to Microsoft 365 suite

MPOG website & CC tools evolving

Accessing broader UM IT resources

Passionate QI subcommittees

Strategic investments in MPOG 3.0

Impact learners and the process of teaching

Create a culture of data driven lifelong learning

Decrease EPIC extract dependence

Modern data extraction informatics & technology

Near-real time feedback and guidance

Unstructured data -> meaningful clinical outcome inferences

Data beyond the OR to floor, ICU, and outpatient

Continued financial stability & value

Resource for surgeons, anesthesiologists, and all clinicians

Technology & process “skunkworks” example

• Leverage UMichigan Anesthesiology Informatics and Systems Engineering Team (MAISE)

• THRIVE demonstrated need for reliable, easy to use PK/PD models to teach TIVA concepts

• Duplicate data entry from EHR challenging

• Build upon national expertise in PK/PD modelling (Utah, Stanford, Partners, etc)

• Integrate publicly available modeling with MAISE expertise in real-time EHR medication

admin extraction: “EHR-integrated” TIVA Model (limited release)

• Robust, reliable “non EHR-integrated” tiva-model.org publicly available

• Effect site concentrations for common anesthesiology meds

“TIVA Model” (EHR-integrated)

TIVA Model (EHR-integrated)

• Beta-testing at Michigan across

dozens of users

• Next site: Utah

• All meds extracted from EPIC

• Refresh q5 minutes

• Can “try out” different doses,

start & stop times to see future

effect site concentration

Pure TIVA Model

Tiva-model.org

Freely available, ready now

Manual medication data entry

Builds upon stanpumpr.org

experience

Clinical trial innovations

• Learning health systems synopsize, evaluate, create and implement evidence

• Observational causal inference has its limits

• MPOG offers a unique prospective, randomized interventional opportunity

• Innovations in

Prospective data collection & preliminary data

Collaboration

Point of care Implementation

Trajectories of Recovery after Intravenous propofol versus inhaled VolatilE anesthesia

THRIVE-ing around the country – 2,940 / 12,500 patients randomized!

THRIVE site PIs

Other clinical trials funded with MPOG as the platform

Precision Feedback

– Customized provider feedback emails within MPOG

– Primary Outcome: Clinician Performance Improvement

– PI: Zach Landis-Lewis (UM), Allison Janda; Funding: NIH

VEGA-2

– Phenylephrine vs Norepinephrine in Non-Cardiac Surgery

– Primary Outcome: Acute Kidney Injury

– PI: Matthieu Legrand (UCSF); Funding: NIDDK

Intraop-Ox

– Oxygen Supplementation Levels for GA in Non-Cardiac Surgery

– Primary Outcome: Composite of morbidity, mortality

– PI: Josh Billings (Vanderbilt); Funding: MPOG & AUA & UM

MPOG “marketing”

• Limited marketing efforts or budget

• Tokens of appreciation to thank you for

your efforts

• MPOG jackets

• Website / link pending

– Pro bono to local site representatives (no

MPOG or site $ required)

– Per unit cost for additional team members

– Please see samples for sizing hanging on rack

Congratulations to Michael Avidan, MBBCh, Getting inducted to NAM !!

October 19

, 2024: Induction Ceremony to the National Academy of

Medicine (formerly “Institute of Medicine”)

One of only 40 new physician 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