ASA, AQI launch next-generation NACOR registry via Epic collaboration
New anesthesia clinical registry promises quality and expanded research opportunities.
February 2026 marked a major milestone for anesthesia quality improvement efforts. That’s when ASA and its Anesthesia Quality Institute (AQI) unveiled a significant advancement in anesthesia data collection with the launch of the Anesthesia Clinical Registry (ACR). The cloud-based platform is powered by Epic and designed to seamlessly integrate with the AQI’s National Anesthesia Clinical Outcomes Registry (NACOR).
According to AQI Board Chair and ASA Past President Randall Clark, MD, FASA, the initiative represents the culmination of years of work aimed at simplifying the flow of clinical data into NACOR, while expanding opportunities for performance measurement, patient safety initiatives, and medical research. Dr. Clark is among the speakers at the Saturday session, “What’s New With NACOR: A First Look at Enhancements, User Experience, and EHR Integration.”
“ACR allows information already available in the Epic EHR to move seamlessly into the NACOR registry and allows AQI to set the parameters to be retrieved and to update the extraction process over time,” Dr. Clark said. “We plan to build on the 18-year history of metric development conducted by ASA’s Committee on Performance and Outcomes Measurement and NACOR to make a robust library of metrics available.”
Those metrics represent performance, operations, and eventually outcomes data. The initiative will allow AQI to track this type of patient information across multiple hospitalizations as long as they occur in Epic facilities, Dr. Clark said.
AQI was established by ASA in 2008 with the goal of improving quality through data-driven insights. Although NACOR has long served as a critical repository for anesthesia outcomes data, Dr. Clark said that efficiently capturing information from clinical settings remained a challenge.
Session speaker Patrick Guffey, MD, AQI Board member, said AQI committees carefully selected the initial data elements to support current quality metrics, noting the potential for AQI to refine and broaden the dataset as the organization builds a more extensive measurement library.
“ASA standardization is an essential component of the work being performed and is important for two reasons,” said Dr. Guffey, a Professor of Anesthesiology at the University of Colorado Anschutz School of Medicine in Aurora, Colorado. “First, standardization across data definitions ensures improved validity and completeness of data within NACOR, and subsequently all reported metrics. Second, a core principle of quality improvement requires standardization so that measurement and iterative improvement can be achieved.”
Initial feedback
Early feedback from the anesthesia community has been overwhelmingly positive, said speaker Sheila Barnett, MD, FASA, a Professor of Anesthesiology at the Geisel School of Medicine at Dartmouth College in Hanover, New Hampshire. According to Dr. Barnett, NACOR is currently taking in data from pilot participants following the ACR launch in February 2026, while AQI gathers insights from early adopters. Although detailed case studies are still being developed, AQI leaders expect to present more comprehensive examples of quality improvement success at ANESTHESIOLOGY 2027.
“We are encouraged by the volume of enthusiasm surrounding the new NACOR registry and the launch of the ACR. This has been very well received by the anesthesia community, from academic centers to private practices, affirming that this is the best path forward for the specialty,” Dr. Barnett said. “We need actionable data, and NACOR will deliver value to our members and our specialty.”
Dr. Barnett said she is encouraged by the interest she sees across stakeholders within the anesthesia space. AQI has been approached by several new start-up companies that are looking to apply artificial intelligence (AI) to large datasets. The institute is also working to explore opportunities with pharmaceutical companies and device makers to align on data needs.
Opening the quality improvement door
AQI is driving innovation across the registry space through this collaboration with Epic. Foundationally, AQI exists to collect and report on data to foster improvements in patient care. ASA serves the specialty and its members in a variety of ways, AQI being one of these resources.
“AQI and ASA are diligently working to provide anesthesiologists and researchers one of the most exciting new data-driven tools for both improving care and improving how we deliver that care,” Dr. Barnett said. “We think AQI and the new NACOR can be a door to a new, innovative world of quality improvement.”
Looking ahead, Dr. Clark said AQI plans to engage additional EHR vendors in similar integrations and eventually explore solutions for practices that still rely on paper-based workflows. The long-term vision is a comprehensive, accessible ecosystem that supports quality improvement across all anesthesia practice settings.
Ultimately, Dr. Clark said the collaboration with Epic is a transformative step for anesthesia quality registries. By reducing barriers to data collection and creating a more robust, standardized source of clinical information, he said the organization hopes to empower anesthesiologists with actionable insights that improve both patient outcomes and operational performance.
