MPOG Plan for Obtaining Outcome Data
Douglas A Colquhoun, MB ChB, MSc, MPH
Assistant Professor of Anesthesiology
Associate Research Director, Multicenter Perioperative Outcomes Group
July 17th 2026
Disclosures:
Research Funding:
–National Heart Lung and Blood Institute (K08-HL159327) [PI]
–National Institute on Drug Abuse (R33-DA059168) [Co-PI]
–Foundation for Anesthesia Education and Research (2021) [PI]
–NIH Common Fund (UM1-NS118922) [Co-I]
–National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK139484) [Co-I]
–Patient Centered Outcomes Research Institute (PLACER-2020C3-21106) [Co-I]
–Agency for Healthcare Research and Quality (R01-HS029172) [Co-I]
Sponsored Research:
–GE Healthcare –[PI]
–Chiesi, USA Inc [Co-I]
Overview/Outline:
•Recap where perioperative outcome occurs
•Discuss the need to expand MPOG data collection
•Discuss Two Potential Approaches Under Consideration
Perioperative Risk Paradox:
•Intraoperative mortality is vanishingly rare
•But death within 30 days of the operating room
would be 3rd leading cause of death in US
•Death occurs during hospitalization, but also
commonly in the near term post discharge
Bartels K, Anesthesiology. 2013
The VISION Cohort:
•Population:
–40,004 patients:
–>45 yrs
–1 night in hospital planned
–Non-cardiac surgeries.
–28 Hospitals across 14 Countries
•715 (1.8%) of patients died in the next
30 days
•“Number of deaths was almost evenly
distributed over 30-day follow-up”
(Spence J, CMAJ 2019)
715
Deaths
500 Deaths
During Index
Hospitalization
210 Deaths
After Discharge
5
Intraoperativ
e Deaths
Willie Sutton (1901-1980)
“Because that’s where
the money is.”
https://www.fbi.gov/history/famous-cases/willie-sutton
Finishing the Race: Outcomes After Anesthesia Care
• Handover to PACU may signify “Anesthesia End”
•Recognizing PACU outcomes is key for intraoperative
technique refinement
•PACU is beginning of patient recovery
•What patients value in recovery from surgery?
–Often expressed in functional terms: return to routine, resolution
of symptoms, regaining independence
•Challenge for us to measure what matters
Rajabiyazdi F. JAMA Surg 2021
Outcome Opportunities:
Partner with Other
Registries
Expand Electronic
Collection
Seek Patient
Reported Outcomes
Example: MSQC SSI
Data on Dashboard
Example: R61 and ADP
(see rest of talk)
Don’t lose focus on
what matters
Two Initiatives To Explore How to Achieve This:
•R61 Project
–MPOG developed reports from Epic
Clarity
–Full form at U-M and in progress at
a test sites
–Tailored to Perioperative Care
–Partially at all State of Michigan
Sites (Race/Ethnicity/SOGI)
•Automated Data Pilot
–Uses a commercial software
interface
–Full form at U-M and in progress at
a test sites
–Broader connection with entire
Electronic Health Record
Common Work to Use and Understand this Information:
App Suite Upgrades
Phenotypes Development to Measure
Quality Measure Development
MPOG Now vs Future State:
Operating Room
Vitals / Monitor Data
Medications
Hospital
Admission
Hospital
Discharge
Laboratory Data
Administrative Data
1yr Prior to Case 1yr After Case
Structured Documentation
Admission, Discharge and Transfer
Patient
Attributes
Procedure Notes
MPOG New Reality:
Operating Room
Vitals / Monitor Data
Medications
Hospital
Admission
Hospital
Discharge
Laboratory Data + Microbiology Data
Administrative Data
1yr Prior to Case 1yr After Case
Structured Documentation
Admission, Discharge and Transfer
Patient
Attributes
Procedure Notes
Laboratory Data
Admission, Discharge and Transfer
R61 Project: Building On Current Approach:
EPIC
MPOG
Local MPOG
Central
Import
Manager
Clarity/
Other Sources
Import Manager is
Source Agnostic:
Links Patients +
Transforms Files
EPIC Controls this:
Changes made q3
yrs
At Each MPOG Site At the Coordinating Center
Patient Attributes
Additional Data Files –Additional Meaningful Information:
Patient Attributes
Microbiology Data
Admission Discharge and Transfer Data
Inpatient Medication Administration
Inpatient Flowsheet Data (Vitals + Structured Charting)
What’s Next?
•Future is beyond the operating room
•Gaining experience and understanding each option
•Pilot implementation of each option continues at small
number of sites
•Big decisions ahead on how to implement the MPOG
beyond the OR approach
•Michigan Sites have been core partners –Thank you!
