Steps for this integration process are outlined below:
- Anesthesiology Clinical Champion: Identify the anesthesiology faculty who will serve as the clinical point-of-contact for your institution. This contact should have established communications with surgery faculty who participate in the target surgery registry (e.g. STS, NSQIP). Usually, the anesthesiology faculty will be either the MPOG Principal Investigator; or in many cases, a clinical faculty within the surgical department of interest (e.g. for STS-Thoracic integration, an ideal faculty would belong to the thoracic anesthesiology division).
- Surgery Clinical Champion: Identify the surgery faculty participating in the surgery registry of interest, who will serve as the clinical point-of-contact for your institution. The Surgery Clinical Champion should be familiar with the surgery registry, and have a clinical working relationship with the Anesthesiology Clinical Champion.
- Anesthesiology – Surgery Registry Information Technology (IT) Champion: Identify an anesthesiology faculty who will work with the developers at their institution and MPOG to integrate MPOG IT infrastructure with surgery registry IT infrastructure. This will usually be the Anesthesiology IT Champion or possibly MPOG Principal Investigator serving a dual-role.
- MPOG IT Support: Identify the IT individual(s) at your institution who will manage your institution’s MPOG integration with the target surgery registry. This will usually be the IT Support individual(s)responsible for exporting data into the MPOG database.
- Surgery Registry IT Support (i.e. Database Manager): Identify the IT individual(s) within the surgery department at your institution who will collaborate with MPOG IT support. These individuals should be involved in the management of the surgery registry of interest.
After completing the steps above, the Anesthesiology Clinical Champion will have a communication with the Surgery Clinical Champion to obtain surgery department approval and foster an environment of collaboration. This is best accomplished via a meeting in person, or via phone/online meeting. For surgery registry integration to be successful, consideration should be given to (i) an established, collaborative clinical environment at the institution, (ii) time availability of personnel involved. At this meeting, we recommend attendance of appropriate contacts:
- Surgery Clinical Champion – mandatory
- Surgery Registry IT Support – recommended
- Anesthesiology – Surgery Registry IT Champion – recommended
- MPOG IT Support – suggested
- Additional committed surgery faculty – suggested
Although we encourage this meeting to be held internally, assistance from the coordinating site can be provided during this meeting at the discretion of the Anesthesiology Clinical Champion.
Goals of this meeting should be:
Once appropriate institutional contacts are identified and Surgery Department Approval is obtained, a Surgery Registry Integration Application Form will be completed and e-mailed to the MPOG Coordinating Center at email@example.com. Within the application, contact information for Key Personnel is provided, and the Anesthesiology Clinical Champion will attest to:
- Having reviewed the Surgery Registry FAQ document.
- Having reviewed their MPOG Performance Site IRB and confirmed that the IRB includes a description of integration of data from the surgical registry noted above (with IRB page number specifying these details).
- Surgery registry details: Prior to database integration, the Anesthesiology IT Champion, MPOG IT personnel, and surgery registry IT personnel should determine several surgery registry attributes:
- Surgery registry vendor, if applicable (e.g. for STS, common vendors include ARMUS, Cedaron, LUMDEX, etc.)
- Date range with complete data available
- Obtain surgery registry file: The surgery registry IT personnel (i.e. Database Manager) will generate a file containing surgery registry data, including patient medical record number (MRN) or unique patient identifier, over a time period for which complete registry data are available. The registry file should be stored internally on a secure server, and the file should be high-quality (i.e. same quality as would be submitted to surgery registry coordinating center, or used for surgery department internal review).
- Obtain MPOG Application Suite and registry import guides: Local IT personnel should download the MPOG Application Suite and the surgery registry-specific import utility guide from the MPOG website downloads page.
As scheduled by the local MPOG IT and Surgery Registry IT, a web meeting will be hosted with the coordinating site (University of Michigan) to navigate the technical aspects of the surgical registry integration. The following personnel will attend:
- Surgery Registry IT (Database Manager) – mandatory
- Local MPOG IT Support – mandatory
- Coordinating Center (University of Michigan) Support – mandatory
- Anesthesiology – Surgery Registry IT Champion – optional
- Anesthesiology Clinical Champion – optional
- Surgery Clinical Champion – optional
During the meeting, the MPOG and Surgery Registry IT personnel will follow the steps in the registry-specific import guide, and import the registry data into the local MPOG database using the data file. Local MPOG IT personnel will then submit imported surgery registry data to the central MPOG database by using the MPOG Application Suite’s PHI scrubbing and transfer utilities.
Following successful initial integration of the surgical registry, the MPOG coordinating center will send a report to the local site, providing details on the quality of the integration:
- Total number of surgical registry cases integrated
- Date range of surgical registry cases integrated
- Match rate of surgical registry cases, to MPOG cases
After receiving the integration quality report, the Clinical Anesthesiology Champion and the Anesthesiology–Surgery Registry Information Technology (IT) Champion will review the report, and if there are remaining concerns, additional meetings can be scheduled with the coordinating center (same personnel attending the meeting, as during the initial surgical registry integration meeting), to review issues and troubleshoot.
Following confirmation of an accurate surgical registry integration, the coordinating center will coordinate a plan with the Local MPOG IT and Surgery Registry IT, to establish a recurring surgical registry integration schedule.