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AnesthesiaOS PONV Office Ad-in uses Azure cloud storage, and Azure Machine Learning to assist anesthesia providers in the preoperative screening of patients for the risk of PONV. If a patient is high risk, notations are placed within the AnesthesiaOS. These notifications are seen as pop-ups that assist with decision support for the providers. This Office Ad-in utilizes Excel to pull data from cloud storage. The interoperability benefits include the use of Azure cloud storage, Azure Machine Learning, and Excel.