The AACVPR National CR Registry
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Transcript of The AACVPR National CR Registry
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The AACVPR National CR Registry
Carl N. King, EdD, FAACVPRPresident and CEO
Cardiovascular Consulting
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Disclosures Consultant for AACVPR Registry Project Consultant for LSI
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Lohr, et al. NEJM, 1990Lohr, et al. NEJM, 1990
Quality Health Care“…the degree to which health service for
individuals and populations increases the likelihood of desired health outcomes and are consistent with current professional knowledge.”
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Outcomes perspectives
PROGRAM: What happens to our patients and how does this compare to other programs?
PROFESSION: What happens to populations of patients as a result of standardized care based on evidence-based guidelines?
PATIENT: Am I better off now after having rehab?
What happened to my patient as a result of my care?CLINICIAN:
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Value =Outcomes
Costs
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If you don’t measure it, you can’t improve it.
If you don’t measure it, you can’t improve it.
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Research tells us what we can do.
Guidelines tell us what we should do.
Registries tell us what we’re actually doing.
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AACVPR Registry CommitteeMark Vitcenda, Chair
Michael McNamara and Bonnie Anderson, Directors
Steven Lichtman, Chris Garvey, Gerene Bauldoff, Mark Senn, Randal Thomas, Anne Gavic, Ken
Eichenauer, Justin Rimmer (Cissec)Joanne Ray, Rod Stiegman, Krista Betts
(Smith Bucklin)
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Corporate Sponsor
Life Systems International
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Corporate Sponsor
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Existing Registries for CAD
American College of Cardiology
American Heart Association– The Guidelines Advantage
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InpatientOutcomes
OutpatientOutcomes
CR Outcomes
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Provide evidence to our customers that cardiac rehabilitation produces
improvements in the patient’s risk factor profile and health status
beyond what can be expected or achieved through “usual care”.
Mission
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Construction Timeline
Launch date: June, 2012* Data tables and interface development
completed Beta testing: Winter 2012 with 8-12
selected programs Improvements based on beta testing
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How will it work? Membership application through AACVPR site
– Do not need to be an AACVPR member or be a certified program to participate
Program agrees to comply with data definitions Program must have signed Participation
Agreement on file
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How will it work? Data entered on every patient enrolled Patient record can be edited at any time Real-time entry or batch uploads via third-party
apps Reports can be printed at any time
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How will it work? Data validated at database level Data transfers secured via SSL/encryption Data and security meet HIPAA
requirements
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Proposed Measures Demographic information
• Unique patient identifiers (MR#, SSN – last 4 digits, Last name)
• DOB (age)• Sex• Race/ethnicity• Admitting diagnoses/procedures/dates• Tobacco use status• Comorbidities (used for “risk adjustment”)
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Proposed Measures Clinical
• HT/WT/BMI• Waist
Circumference• Blood pressure• Lipids
• FBG, A1c (DM only)• Estim exercise capacity (METs)• Functional Status• +/- depressive symptoms
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Proposed Measures Behavioral
– Adherence to:• Exercise/Physical activity• Medications (ASA, BB, ACEI, statin)• Tobacco cessation• Influenza vaccination
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Registry InstrumentsDietary % saturated fat
Servings Fruits/vegetables per dayPhysical Activity Pedometer (steps/day)*
Duke Activity Status Index IPAQ
HRQL MacNew Quality of Life* SF-36 v2* Ferrans & Powers QLI Dartmouth COOP
Depression PHQ-9
* Requires licensing fee
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Registry Reporting
Individual patient outcomes Aggregated outcomes for program Program performance based on guidelines Program performance based on registry
aggregates– Benchmarking to like-size and state
User-defined queries
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Registry Reporting
Only your program will have access to your data and results
Results can be used to manage care of patients, to track individual patient outcomes or general program performance
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HIPAA, PHI and the Registry Use of Protected Health Information (PHI)
– Minimum amount of patient identifiers used for connection to ACC registries, Medicare administrative databases
Will require Participation Agreement between AACVPR and your program
PA will include Business Associate Agreement and limited Data Use Agreement
Review by Mayo Clinic IRB
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Connecting to the Registry:Application Programming Interface (API)
Allows 3rd party applications to upload local data to registry
AACVPR working with LSI, ScottCare and Cardiac Sciences on creating uploading methods from their applications to registry
Home-made databases may require custom solutions
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ProgramCertification Registries
Data
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Training and support Education Promotion Funding support
Training/supportTraining/support
Funding supportFunding support
PromotionPromotionEducationEducation
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Training and Education
Each program to designate “Principal User”
Training required to ensure accurate data collection and reporting
On-line help and technical support through AACVPR and Cissec.
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Training and Education
AACVPR will provide outcomes education through webinars, podcasts, articles– How to analyze Registry data– How to use data to improve patient care– How to do QI projects to improve program
performance
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Membership fees Annual user fee: $100-$150 Based on program size
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Key Points
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ValueValue
ScopeScope
FunctionalityFunctionalityQualityQuality
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Key Points June, 2012 launch date for CR registry Beta testing ongoing with selected sites
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Key Points Participation not required, but encouraged
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Key Points Do not need to be an AACVPR member or
be AACVPR-certified to participate
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Key Points Registry membership/subscription will be
on-line through AACVPR
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Key Points Membership cost minimal--$100-150
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Key Points AACVPR will provide lots of training,
education and support as needed
“We’re here for you!”
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Key Points Data bridges/pipelines (APIs) from
telemetry vendors and other data sources planned to make data entry easier
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Key Points Will require adjustments to program
protocols for maximal benefit
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Key Points Certification and Registry applications
linked for easy data transfer between both applications
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Key Points The CR Registry will help programs
manage and analyze their outcomes data and promote improvements in patient outcomes, improvements in program procedures, and overall improved utilization and recognition of CR services.
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Key Points Note: The National PR Registry will launch
in June, 2013. This is to give time for us to learn from the CR Registry and make improvements as needed to the PR Registry.
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Thank you
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?questions