Data Points: ACC Chapters Championing Registry Use

NCDR | ACC’s Chapters are taking an active role in the promotion of tracking quality through wider adoption of NCDR’s hospital and outpatient registries.

In Puerto Rico, the ACC Chapter is leading efforts to engage physician champions, nurses and administrators from several hospitals in understanding the value and benefits associated with registry use. In February, NCDR staff and member leaders provided a one-day educational symposium focused on how to get started, keys to success and how to make registry use sustainable. Looking ahead, the Chapter is planning to develop a support system based on a coalition of hospitals committed to developing and sustaining NCDR registry use.

Back in the lower-48, the Virginia Chapter has been invited by the Virginia Cardiac Services Quality Initiative to partner on changing its focus from measuring surgical outcomes to measuring overall quality. As part of this effort, the Chapter will merge CathPCI Registry data with data from The Society of Thoracic Surgeons – a move that can provide glimpses of patient care beyond the inpatient stay.

Adoption of the ACC’s outpatient PINNACLE Registry is also on the rise across the U.S. as more and more practices learn about the benefits in both tracking quality of care and meeting Physician Quality Reporting System (PQRS) requirements. For 2014, the PINNACLE Registry reported on data for 1,810 providers across 121 practice groups – potentially yielding up to a 0.5 percent incentive on 2014 claims and protection from an automatic -2.0 percent adjustment on 2016 claims. Submission also meets requirements for value-based payment modifier reporting, protecting against a further automatic -2.0 percent penalty.

Outside of PQRS reporting, states are also using the PINNACLE Registry for quality improvement. For example, the Mississippi Department of Health has entered into an agreement with NCDR to act as a third party to monitor the state’s ST segment elevation myocardial infarction network hospitals and confidentially promote quality within each institution while otherwise keeping data blinded to competing institutions.

Famed author and management consultant H. James Harrington, PhD, said: “Measurement is the first step that leads to control and eventually to improvement. If you can’t measure something, you can’t understand it. If you can’t understand it, you can’t control it. If you can’t control it, you can’t improve it.” With health care increasingly moving toward a system focused on quality, outcomes and cost-effectiveness, ACC Chapters are, and will continue to play, a leading role in helping hospitals and practices take this first step toward measurement and control. The end goal: a health care environment that is safer, more effective and patient-centered.

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Data in Action: Published Research Using NCDR Data

Care Registry | There is little difference in using a distal filter EPD or a proximal EPD to prevent an embolism during carotid artery stenting. Both work equally well and have similar low rates of in-hospital and 30-day stroke or death, according to a study published April 20 in JACC: Cardiovascular Interventions. The first comparative effectiveness analysis on this topic, the study used data from the ACC’s CARE Registry, now the PVI Registry, and assessed records from 10,246 patients who had elective carotid stent procedures with embolism protection between January 2009 and March 2013.

CathPCI Registry | Prospective risk stratification before percutaneous coronary intervention may increase the use of avoidance strategies and lead to a 44 percent decrease in the odds for bleeding, according to a study published March 24 in BMJ. Using data from the ACC’s CathPCI Registry, researchers looked at records from 10,937 patients between March 24, 2010, and May 5, 2011. Their goal was to compare use of bleeding avoidance strategies before the availability of a consent form that included individualized estimates of bleeding risks and after the intervention was implemented.

STS/ACC TVT Registry | A transcatheter mitral valve repair (TMVR) with MitraClip has been commercially proven as a safe, effective treatment for symptomatic mitral regurgitation patients with prohibitive surgical risk, according to findings from the STS/ACC TVT Registry that were presented during ACC.15 in San Diego, CA. This late-breaking clinical trial studied all commercial TMVR cases with MitraClip included in the registry, for a total of 564 participants across 61 health care centers in the U.S. The study examined 30-day patient outcomes for procedural success, complications and device-related events.

IMPACT Registry | There is little difference in adverse events between diagnostic and interventional procedures in patients with congenital heart defects, but there are significant differences among age groups, with newborns at the highest risk, according to a study published Feb. 23 in Cardiology in the Young. The study used data from the ACC’s IMPACT Registry between January 2011 and March 2013, and researchers assessed records from 19,797 patients. Of that number, 35 percent of procedures performed were for diagnostic purposes and 65 percent for interventions.

Keywords: Cardiology Magazine, ACC Publications, National Cardiovascular Data Registries, Myocardial Infarction, Outpatients, Patient Care, Quality Improvement, Registries

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