On Monday I attended a plenary about managing patient expectations in the face of the current cost-savings-focused environment. As doctors, we sometimes find that patients want the most expensive care or the most tests as part of their treatment because they view it as the “best” care they can receive. However, this usually isn’t true. The best care is the care that’s been validated by science – and high quality science at that. This can be difficult to come by, even in the field of cardiology, which compared to other specialties, has some of the best research available.

Why does cardiology have some of the best, most comprehensive research? Because cardiology has registries, and we use them to collect data in real-life, which we then turn into the research that informs the clinical documents that guide everyday practice. The ACC has a suite of six registries (NCDR) that together pull research from nearly 2,000 hospitals and 180 practices (yes, one of those registries is an ambulatory registry – the PINNACLE Registry -- formerly called the IC3 Program).

At AHA, research from the NCDR is making quite an appearance. There’s a total of 14 abstracts from the NCDR out at AHA, which hopefully you had the opportunity to check out: five abstracts from the CathPCI Registry; four from the ICD Registry, one from the CARE Registry, two from ACTION®-GWTG™ and two from the IC³ Program (now the PINNACLE Registry).

Of particular excitement are the two abstracts from ACC’s IC³ Program/PINNACLE Registry. The first is an oral presentation by Paul S. Chan, M.D., M.P.H., on “A Report of the First 10,000+ Patients.” The study found nearly three in five enrolled patients had coronary artery disease (CAD) and all the outpatient performance measures (PMs) could reliably be assessed. Adherence to the CAD PMs was often suboptimal, suggesting substantial opportunity for improving the quality of outpatient care.

The second (a poster presentation by ACC staff members Kristi Mitchell, M.P.H., and Sunil Gupte, Ph.D.) is “Electronic Medical Record Adoption in Cardiology Practices: A 2009 Snapshot.” This study found EMR adoption within PINNACLE Registry (then the IC³ Program) is slightly greater than that reported in the literature and may be due to the greater number of large practices enrolled. The PINNACLE Registry provides a foundation to analyze EMR adoption and implementation rates in U.S. cardiology practices and to observe trends associated with reducing some of the financial barriers due to the recent provision of federal funding. As such, the PINNACLE Registry will be positioned to determine the impact of EMR usage on clinical quality and patient outcomes.

The large number of abstracts presented at the meeting is a testament to the rich evidence coming from these groundbreaking registries. We need to keep moving forward with our efforts so that ALL clinical decisions can be made on the basis of the strongest level of evidence.

UPDATED: 11/19 with video.

[youtuber youtube='http://www.youtube.com/watch?v=F3L6znMZiuQ']

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