Postoperative morbidity and mortality in United Kingdom is a serious public health burden. There are 10million surgical procedures of which 1.5 million are considered as major or high risk. Average risk of death is between 2-5% depending on age, additional ill health, severity and urgency of surgery. Morbidity from post operative complications is between 10 – 20% on average but major emergency surgery has a much higher rate. Clinicians are changing the way they work to integrate care through out the entire perioperative patient journey from contemplation of surgery to completion of recovery. Such clinical transformation could save many lives and improve quality of life after major surgery but cannot occur with out concurrent digital transformation. Unfortunately healthcare organisations have been unable to leverage benefits advanced informatics such as analytics. Poor information veracity is a critical factor that has limited use of analytics that could improve patient outcomes. To support the clinical and digital transformation needed for improved perioperative outcomes with analytics a group of key stakeholders in industry, academia and healthcare is hosting an innovation weekend for major surgery. Our aim is to highlight the role of open information standards in leveraging the benefits of analytics for care of patients undergoing major surgery. We are calling for digital ideas that could transform one or more of the four key elements of the patient pathway from contemplation of surgery to completion of recovery and everything in between. The group is calling this pathway the Total ERAS approach to perioperative medicine. It combines an already established concept of enhanced recovery for surgery and expands it to fit the longitudinal dimension of the entire patient journey. Each element is outlined in figure 1 above. A number of ideas within each domain already suggested and are outlined below.
We need a multidscip[inary team to maximise the impact of the weekend. Patients with ideas about thier own perioperative journey are especially welcome.