John S. Rumsfeld, MD, PhD, is chair of the Management Board and chief science officer of the ACC's National Cardiovascular Data Registry® (NCDR). He previously led the development and implementation of the VA's Clinical Assessment Reporting and Tracking Program.

Not surprisingly, his research in recent years has focused on the effectiveness and safety of CV care delivery and therapeutics, building on his work with the ACC, NCDR, and the VA. CardioSource WorldNews talked with Dr. Rumsfeld, chief science officer of the NCDR, about how the registry should be thought of as more than just a repository of national data.

Rick McGuire: The NCDR is a rich source of information. Besides being able to read some very interesting research papers, what does the NCDR mean for the practicing clinician? Immediately prior to ACC.13, you had your annual NCDR meeting. For you, is NCDR fun at this moment?

John S. Rumsfeld, MD, PhD: NCDR is very fun at this moment; it has grown tremendously. It used to be a small endeavor—a single registry—it's now seven national programs. It used to be something separated a bit from what we do as clinicians in our daily work; now it's becoming integral to what we do in our daily practice. It's growing and becoming more and more relevant and providing value to ACC members in their daily work. That's pretty fun.

In CardioSource WorldNews, we regularly report data from NCDR because there are fascinating papers derived from NCDR. For the practicing cardiologist, what does the NCDR have to offer? That's the great question: people do focus on saying, "It's a registry, so it's just about data or the research." Both are important, but what they're missing is that we're working very hard for NCDR to have direct relevance to clinical practice.

Let me give just a couple of examples: One is tied to education. We all know that we're under increasing pressure for maintenance of our various certifications and maintenance of licensure. NCDR data are now being used for the first time for maintenance of certification credit. For the first time at our NCDR meeting, we had a physician administrator track and it sold out. This was the pilot for a program where people use the NCDR data from their own practices or their hospitals, and the ACC gave them American Board of Internal Medicine Maintenance of Certification (MOC). So, in the future, you're going to be able to come to this meeting and others, work with your NCDR data from your practice or hospital, and get your MOC credit for that.

The second thing is quality reporting. We're all being measured, and we have to report to this insurance company, to the federal government, to the state government. Increasingly we're getting the ability for your NCDR data to be used instead of administrative claims data for that. The various entities are buying into the idea where you'd have control over your own data, from your practice or your hospital, and that can be used as your quality reporting.

One issue that occasionally crops up is someone will get an NCDR report, and they're not sure what they're looking at. How much education is involved in understanding what you're seeing?

It's pretty straightforward, but you hit the nail on the head. Just like we wouldn't go in and do any new procedure or go into a new clinical area without at least getting some education, input, or training on it, it's the same thing for quality. We're putting together quality training—both didactic, to get MOC part 2 credit, and a training session on how to read and use your NCDR data to get MOC part 4 credit, which is what we offered at our pilot program at our NCDR meeting and again at ACC.13. By next year, we hope ACC members will be able to sign up, learn how to read and interpret their reports, use them for meaningful performance improvement, and get credit for them.

This move toward quality is not going to stop. Our cover story in the March issue of CSWN was on the "Valley of Death" as some experts are calling this very difficult period health care is going through right now. The emphasis from all the experts was: if you're waiting for this emphasis on quality to go away, it's not going to.

I completely agree. It is a very cloudy, if not smoggy, health care environment that we are living in, and there's no single solution to that. However, let me pose this question: Right now it feels like much of this is being done to us, but why can't we use our clinical data, which we have some control over, as the way our quality is judged?

Too few clinicians think they have control over the NCDR data—you do. It's data capture, not just collection. For most cardiologists, the hospitals or hospital systems you are affiliated with, integrated with, or work for are having these data collected. You should go find the performance improvement people in the hospital, go get your NCDR reports, and sit down with them. They are your data and you should have them reported for you.

For people who want to find out a little more about NCDR, how do they do it?

Go to www.ncdr.com  and it pretty much has everything you need there about the quality efforts underway and the research going on. For any ACC member, I would be more than happy to hear from them directly: john.rumsfeld@ucdenver.edu.

Keywords: Federal Government, Registries, Licensure, Certification, State Government

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