I was excited to be asked to attend to an invitation-only CMS meeting on Thursday of 25 leaders and CEOs of a few health constituencies with federal officials to discuss the potential of using registries and clinical data to improve care and lower costs (at long last). The gathering was co-chaired by CMS Administrator Don Berwick and Harvard Business School economist and health policy strategist Michael Porter. Berwick asked me to make some opening statements, and I presented the ACC experience and vision for NCDR, PINNACLE, and registries in general. What an opportunity! The few people invited were those he felt had influenced him along the way on the importance of using registries to achieve the triple aim (improving health care, improving health, lowering costs). It was a very good conversation.

Michael Porter discussed his research on registries in other parts of the world, and what they are accomplishing when done right. He noted that wherever he looks, that registries -- even voluntary ones -- improve outcomes, and this leads to improved clinical care models and lower costs. His data from Sweden is compelling. Interesting that this week’s JAMA highlights Sweden’s registry-produced data demonstrating the clear association between adoption of evidence-based guidelines and improved survival for ST-elevation myocardial infarction. We need more research of this kind here.  The guidelines are valuable -- along with clinical judgment.

Berwick may have been steering this conversation toward opening the doors to more federal support for registries and clinical data. The Office of the National Coordinator for Health IT is definitely on board, too. Farzad Mostashari (its head) is a big supporter of ACC and STS as well.

So what was the bottom line here?  Progress was made; but believe me there’s more convincing to do. More federal officials and agencies apparently see the value and necessity here of getting clinical data, adherence to guidelines (or routine comments as to why not), and routine feedback on performance to doctors and hospitals. The final agreement was to have follow-up calls, and to explore how to fund some diffusion of registries through the CMMI (CMS Innovation Center) and AHRQ.

We at ACC and STS need to assure that the follow through on our part will occur. We've been lobbying for registry awareness for far too long. 

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