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Division mines perioperative data to enhance safety, quality

Feb. 13, 2014, 8:49 AM

VAPIR Division members include (front row, from left) Lana Sain, Christopher Eldridge, Michaelene Johnson and Catherine Bulka, (back row, from left) Dylan Snyder, Jonathan Wanderer, M.D., M.Phil., Jesse Ehrenfeld, M.D., MPH, and Damon Michaels. Not pictured: Karen McCarthy and Maxim Terekhov. (photo by John Russell)

The Vanderbilt Anesthesiology and Perioperative Informatics Research (VAPIR) Division was recently established to extract and analyze data from Vanderbilt University Medical Center’s archive of de-identified perioperative patient data comprising more than 729,000 completed surgical cases to help improve patient safety and quality of care.

The VAPIR Division, recently established within the Department of Anesthesiology, includes seven full-time research support staff, and its multidisciplinary members are now managing more than 70 active clinical research and operational projects.

The group evolved out of a more informal collection of researchers already working within the department. The division is led by Jesse Ehrenfeld, M.D., MPH, and Jonathan Wanderer, M.D., M.Phil.

The team has developed a data repository known as the Perioperative Data Warehouse, which leverages Vanderbilt’s unique information systems infrastructure to collect and store data from multiple systems across the enterprise. Because of this resource, the VAPIR Division can easily access, sort and analyze large historical datasets and can quickly provide summaries of those analyses for their own research development, as well as for use by other internal or external research partners.

The data warehouse now contains more than 9 billion data points. In addition to mining historical data, the VAPIR Division takes the lead in evaluating the impact of technology and information management systems within the operating room.

“We’ve positioned the VAPIR Division to lead perioperative informatics research at Vanderbilt,” said Warren Sandberg, M.D., Ph.D., chair of the Department of Anesthesiology. “It’s rewarding to know that decisions based on the data we provide groups throughout the clinical institution will help ensure that the safety and quality of patient care are never compromised and that improvements are made that are founded on the VAPIR Division’s many initiatives.”

Discoveries made by VAPIR Division researchers have already led not just to the creation of new knowledge, but in many cases, have resulted in the direct improvement of care and operative outcomes of Vanderbilt patients. Examples include improved strategies to manage patients with diabetes having surgery, an effort to reduce the costs of drugs and supplies used during surgical cases and a study to decrease post-operative complications, including hospital readmissions.

“Our goal is to turn data into information through the creation of tools that can be easily used by researchers, analysts and bedside clinicians,” said Wanderer.

The work accomplished by VAPIR has also led to recognition of Vanderbilt as home to one of the premier anesthesia informatics research programs in the world, and this has resulted in many productive partnerships and collaborations. In 2013, members of the division published 25 papers and presented 23 abstracts at external scientific meetings.

“We are appreciative of the opportunities for our group to partner not only with collaborators at Vanderbilt, but also with colleagues performing research across the nation and the world,” said Ehrenfeld. “Through these collaborations, we have been able to establish and strengthen our group’s mission to promote patient safety and quality of care, both here and abroad.”

One such collaboration is with the National Institutes of Health-sponsored U.S. Critical Illness and Injury Trials Group, in which Vanderbilt is co-leading an effort to bring together de-identified, high-resolution intensive care unit data from a consortium of medical centers. This allows researchers across the country to quickly and efficiently answer important questions about how to best care for critically ill patients.

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