For over two decades, the ACC has invested significant resources in the collection, aggregation and analysis of health care data, specifically in the realm of clinical data for registries through the NCDR. Given the ACC’s expertise in transforming cardiovascular care through pioneering the use of clinical data registries and appropriate use criteria, when the Senate Finance Committee solicited input from the health care community for ideas to enhance the availability and proper utilization of health care data, ACC was well positioned to respond.

According to the Senate Finance Committee, "Health care-related data, specifically, is a growing but largely untapped resource for accelerating improvements in health care quality and value. This data has great potential for use by consumers who can be empowered to choose providers that best fit their specific needs; by providers who can improve and deliver higher-quality care; and by payers who can design the most efficient and effective delivery models."

In a letter to Sens. Ron Wyden (D-OR), Finance Committee chairman, and Charles Grassley (R-IA), senior Finance Committee member, the ACC addressed data sources that should be made more broadly available; how this data should be conveyed; reforms that would help reduce the unnecessary fragmentation of health care data and improve the accessibility and usability of this data for consumers, payers, and providers; and barriers to using existing data sources more effectively.

The College made the following recommendations: 

• The ACC believes that voluntary public reporting of quality measures will inform the public in their selection of a physician or hospital services, and will also act as a powerful incentive to improve performance.
• In order to develop valid publically reported measures and provide them back to clinical care teams in an actionable way, the ACC needs timely access to mortality data and Medicare claims data.
• Education about data sets should begin before the release of the publically reported results. Formats should be standardized, as should terminology.
• CMS should compare the physician claims data collected as part of the Qualified Entity Program against clinical data in order to improve quality of patient care.
• The ACC urges Congress to reevaluate the role of the Health Insurance Portability and Accountability Act (HIPAA), its successes and failures and whether all aspects of HIPAA remain appropriate given today’s technology and the foreseeable future.
• The ACC encourages Congress to support funding of national medical specialty societies to aggressively advance the informatics of data standards and terminology, placing us one step closer towards the electronic exchange of health information and enabling us to truly compare standardized health data.
• The Electronic Health Records Incentive Program should focus less on process and more on usability and enabling the electronic exchange of health data.

Overall, the ACC believes that certain sources of health care data should be made more readily available. Public reporting is a strategic objective of the College, as described by William A. Zoghbi, MD, MACC, past president of the ACC in the Journal of the American College of Cardiology. The ACC has been addressing this topic since 2008 when it released a health policy statement in response to the growing role of public reporting in health care. This year, the College is taking things one step further by marrying quality improvement with patient engagement. Later this month, all hospitals participating in NCDR will have a Hospital Profile established on CardioSmart.org, ACC’s patient-facing portal dedicated to enhancing the patient-clinician relationship. Through these profiles, patients, caregivers, and other stakeholders will be able to identify hospitals that meet specific criteria (location, hospital name, services provided) and learn about their NCDR-related quality measurement efforts. These hospital profiles will allow patients to better understand the quality of care being provided in their area and make more informed care choices.

The effective use of health care data is sure to be a hot topic during ACC’s Legislative Conference and beyond and the ACC will continue working with Congress on these efforts.

Keywords: Electronic Health Records, Health Policy, Quality Improvement, Registries, Patient Care, Health Insurance Portability and Accountability Act, Delivery of Health Care, Quality of Health Care, Centers for Medicare and Medicaid Services, U.S., Data Collection, Medicare, Caregivers

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