March 3, 2016

Anesthesiology debuts new patient outcomes system

The Vanderbilt Anesthesiology and Perioperative Informatics Research (VAPIR) Division has launched a novel system that connects clinicians in the Department of Anesthesiology to their patients’ outcomes.

by Renuka Christoph

The Vanderbilt Anesthesiology and Perioperative Informatics Research (VAPIR) Division has launched a novel system that connects clinicians in the Department of Anesthesiology to their patients’ outcomes.

The system uses Vanderbilt University Medical Center’s (VUMC) archive of perioperative patient data from more than 932,000 anesthetics, combined with institutional data sources, to foster more integrated care teams.

The VAPIR Division, led by Jonathan Wanderer, M.D., MPhil, and Jesse Ehrenfeld, M.D., MPH, includes seven full-time research support staff and manages dozens of active clinical research and operational projects.

Recent projects have been developed to support the transition from traditional fee-for-service reimbursement to bundled payments and value-based care, which demand a focus on efficiency and outcomes.

“We created a system that meets the needs of our clinicians and our changing health care landscape,” said Warren Sandberg, M.D., Ph.D., chair of the Department of Anesthesiology.
“Important outcomes such as length of stay, readmission, acute kidney injury, myocardial infarction, post-operative respiratory failure, rapid response team calls and ICU utilization are automatically tracked and sent to anesthesia providers in a personalized, weekly email.”

The development of VAPIR’s patient outcomes system leverages prior research by the team, which blends data from VUMC’s laboratory systems, billing systems, admission systems, LifeFlight and other sources to build a patient-centered, comprehensive set of outcomes. With the right data models created, the only remaining task was to connect clinicians to their patients.

“Our goal is to make it easy for our clinicians to see the impact their care in the operating room has on our patients’ outcomes, and become actively involved in the important care design work underway at VUMC,” said Wanderer.

“We surveyed our department and the results were clear: 87 percent were not satisfied with the amount of feedback they received. We are fixing that.”

On top of creating communication systems, the VAPIR team has developed tools that help standardize care and support the Department of Anesthesiology’s Perioperative Consult Service.
In partnership with VUMC surgeons, these efforts have resulted in substantial reductions in length of stay for the selected patient populations where they have been applied.

In addition to work on outcomes projects, VAPIR has developed collaborations with many other research groups.

“We are always appreciative of opportunities for our team to partner with researchers here at Vanderbilt, as well as with teams across the nation and the world,” Ehrenfeld said.