JACC Papers Review Current Benefits of NCDR Registries; Identify Opportunities For Ongoing Optimization

ACC’s suite of NCDR registries and their roles in supporting physicians, hospitals, health systems, payers, regulators, patients, researchers and other stakeholders in efforts to improve the quality and outcomes of cardiovascular care are the focus of two recent pieces published in the Journal of the American College of Cardiology (JACC). The papers provide insights into the NCDR data quality process, as well as opportunities to transform the role of registries to improve health care value now and into the future.

In a JACC State-of-the-Art Review, authors David J. Malenka, MD, FACC, past chair of NCDR’s Data Quality Subcommittee, Deepak L. Bhatt, MD, MPH, FACC, and others, provide an overview of the NCDR Data Quality Program and its importance given the unique role registries play in efforts to “support quality improvement at the provider, institutional, state and national levels; evaluate practice patterns (i.e., appropriate use) and medical devices; inform comparative effectiveness research; inform treatment choices; and disseminate best practices to improve patient care.”

The NCDR registries are a valuable source of information on contemporary cardiovascular practice,” they write. “The NCDR [Data Quality Program] is an ever-expanding and continuously improving effort to optimize the contributions of the registry programs to patient care and our understanding of clinical practice.”

The Data Quality Program process, which is outlined in depth in the paper, incorporates the option to use certified software to upload data from existing hospital systems and guarantee data compatibility; comprehensive training of new sites; regular checks to ensure data validity and completeness or identify outliers; and an annual data audit. According to the authors, data accuracy from 2013 to 2020 was “very good, but variable” with room for improvement. In 2019, 95.8% of the data submissions across all registries were complete, with only 3.6% of submissions considered incomplete and missing some data and 0.6% failing to pass the validity test.

Looking ahead, the authors highlight the importance of taking a multifaceted approach to enhance data accuracy – an approach that requires “greater focus on providing clear and actionable data definitions, ensuring consistency across registries and adequate lead time to train data abstractors before implementation.” They also note ongoing efforts to shorten the time between data collection and audit completion.

A separate perspective by John A. Spertus, MD, MPH, FACC; Michael J. Mack, MD, MACC; and Erik Magnus Ohman, MD, FACC, builds on the opportunities for NCDR optimization and proposes potential strategic directions to help improve the patient experience and patient outcomes, as well as lower costs. Specifically, they highlight ways NCDR can help engage patients with shared-decision making, support improved payment structures, facilitate evidence-based protocols of care; foster a culture of improvement; and more.  “For more than 25 years, the NCDR has served as a remarkable example of professional leadership, supporting quality improvement and research,” they write.

Optimizing NCDR is a strategic priority of the ACC and efforts are well underway to reduce the burden of data collection while exploring additional sources of data; enhance NCDR value to stakeholders; promote local, regional, national, and international quality improvement; and support population health management through advocacy and generalizable information. Learn more about the NCDR at CVQuality.ACC.org.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention

Keywords: Percutaneous Coronary Intervention, Physicians, Patient Care, Decision Making, Patient Outcome Assessment, Hospitals, Registries, Population Health Management, Leadership, Comparative Effectiveness Research, Quality Improvement, Data Accuracy, National Cardiovascular Data Registries

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