Surgical Registry Integration
Through tracking perioperative care practices, the MPOG consortium has been able to drive research and quality improvement efforts leading to multiple publications and quality reporting tools. Similar accomplishments have been made with surgery registries. Through database integration, however, there is great potential for new lines of research and cross-departmental collaboration leveraging the strengths within each database.
MPOG strives to build these promising new lines of research, and invites surgeons as collaborators in this process. 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 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 Information Technology (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 Information Technology (IT) Support
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.
- Coordinating Site Approval
Once appropriate institutional contacts are identified, the Anesthesiology Clinical Champion will contact clinical faculty at the Coordinating Site (University of Michigan) for surgery registry integration approval. Depending on the target surgery registry, this will be an e-mail communication to:
- Society of Thoracic Surgeons (STS): Michael Mathis
- National Surgical Quality Improvement Program (NSQIP): Leif Saager
- Michigan Surgical Quality Collaborative (MSQC): Nirav Shah
- Michigan Value Collaborative (MVC) or other: Sachin Kheterpal
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.
- Surgery Registry Integration Checklist
Upon coordinating site approval, a Surgery Registry Integration Application will be completed and e-mailed to appropriate coordinating site contact above. Within the application, the Anesthesiology Clinical Champion will attest to having reviewed the Surgery Registry FAQ document.
- Obtain surgery departmental approval at institution
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. 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:
Can occur concurrently with Steps 3
- 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
- Surgery registry sample test file
The Anesthesiology IT Champion and MPOG IT personnel will request surgery registry IT personnel to generate a test file containing surgery registry data, including patient medical record number (MRN) or unique patient identifier, over an approximately one-month time period for which complete registry data are available. The registry test file should be stored internally on a secure server, and the test 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).
- Upload surgery registry import utility from coordinating center
Anesthesiology IT Champion and MPOG IT personnel will receive a surgery registry-specific import utility from the MPOG coordinating center. Surgery registry-specific import utilities can be found here.
- Host meeting(s) to import of surgery registry sample test file
After obtaining Surgery Clinical Champion approval, the Anesthesiology IT Champion and MPOG IT personnel will host a web meeting with the MPOG coordinating center (University of Michigan) IT personnel and Surgery IT personnel. Prior to the meeting, the participating site will be assigned a coordinating site IT support contact. During the meeting, coordinating center IT support will monitor and assist with the import of surgery registry data, maintained and stored locally within a protected database owned by the institution’s MPOG IT personnel. Imported test file data will then be examined and compared to the original surgery registry test file to ensure accurate data transfer and successful matching to a unique patient identifier.
- Perform surgery registry database integration
Upon ensuring accurate transfer of a sample test file, the Anesthesiology IT Champion, MPOG IT personnel, and Surgery Registry IT personnel will collaborate to perform a full import of surgery registry data to a protected MPOG database stored locally at the institution. Imports will then continue on a regular basis.
- Submit Limited Dataset to Central MPOG Database
MPOG IT personnel will then submit imported surgery registry data to the Central MPOG Database. This process will parallel submission of MPOG datasets to the Central MPOG Database as completed using the provided transfer utility.