The Anesthesia Service of the San Francisco VA Health Care System (SFVAHCS) provides exceptional clinical care; educational experiences for anesthesia residents, medical students, and pain fellows; and conducts clinical research and development. The SFVAHCS Anesthesia Service provides cardiac and non-cardiac operating room care; ICU care; anesthesia for non-operating room care in GI, cardiology, radiology, and psychiatry; acute and chronic pain services; emergency airway management; a comprehensive simulation program for quality improvement; and staff, resident, and student education. SFVAHCS research programs include big data epidemiology projects on developing and testing the safety and efficacy of medications; machine vision based remote, non-contact monitoring; monitors for depression, pain, and neurocognitive testing; drug development for PTSD; as well as developing a nationwide quality improvement program for VA anesthesia care, reviewing 600,000 cases per year in 140 facilities. Dr. Julien Cobert published on the non-contact, remote machine vision-based pain meter. Dr. Art Wallace submitted the AVD-M monitor FDA pre-submission. We continue to develop VA-AnesQIP, a 140-hospital quality improvement (QI) system based on big data techniques. Art Wallace, MD, PhD Chief of Anesthesia, VA Health Care System Clinical highlights Adult Critical CareAmbulatory Surgery CentersBCH OaklandClinical AffairsMission Bay AdultCRNAsMount Zion Surgery CenterObstetric AnesthesiaPain MedicinePediatric AnesthesiaUCSF Orthopaedic InstituteVA Health Care SystemZuckerberg San Francisco General