Why ACTION - Chapter Affairs Extranet
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ACTION Registry
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Objectives of the NCDR Registries
• Provide data standardization
• Provide data that is
– Relevant, Credible, Timely, Actionable
• Present real life outcomes that help providers
improve care
• Help Participants meet consumer, payer, and
regulator demands for quality care
Background
• In 2004, the prevalence of CAD was 15.8 million
in the U.S., causing one in five deaths1
• In 1997, there were over five million visits to U.S.
emergency departments for the evaluation of
chest pain and related symptoms.3
• There is strong evidence that the best
treatments and strategies for these patients are
not always utilized.
Background Cont.
• Recent registries have documented patterns of care for
ACS, and have demonstrated that guidelines adherence
is sub-optimal for a large proportion of ACS patients.
• Despite targeted quality improvement efforts within these
registries, treatment patterns for many high-risk subgroups of patients remain sub-optimal and treatment
disparities persist.
• The ACTION Registry™ has thus been created to
provide among the largest, most comprehensive national
ACS database and quality improvement initiative ever
developed, enabling hospitals to measure their
performance in treating patients with ACS against
national benchmarks.
Purpose of the ACTION Registry
• A national surveillance system
– Assess characteristics, treatments, and outcomes of patients
hospitalized with ACS
– Focusing on high risk patients with STEMI and NSTEMI
• Optimize outcomes and management of ACS patients
– Implement evidence-based guideline recommendations in
clinical practice
• Facilitate efforts to improve quality & safety of ACS care
• Investigate novel quality improvement methods
ACTION Registry™ Audience:
Cardiologists, emergency medicine physicians, hospitalists,
primary care physicians, nurses, physician assistants,
nurse practitioners, pharmacists, case managers, allied
health care personnel, hospital quality improvement
personnel and administrators, professional
organizations, accrediting organizations, regulatory
agencies, payers, pharmaceutical and device industry,
and clinical research organizations
120
ACTION Registry Participationt
101
93
100
80
Facilities
Registry
• No charge for participation
• Funding provided by
– Genentech
– Bristol-Myers Squibb and
Sanofi Partnership
– Schering Plough
Corporation
• CRUSADE and NRMI sites
enrolling
• V1 launched
• V2 being developed with
CathPCI v4 for linkage
Data Sharing
• Early discussions with payers
Research
• Will be initiated in 2007 Q3
60
60
0
44
51
49
49
51
52
66
65
4/7/2007
4/20/2007
38
35
40
20
51
26
12
1/1/2007
59
25
2/1/2007
3/1/2007
3/21/2007 3/30/2007
CRUSADE Participants
Non CRUSADE
About the ACTION Registry
• National registry
• Represents two prior ACS registries
– NRMI (National Registry of Myocardial Infarction) and
– CRUSADE (Can Rapid Risk Stratification of Unstable Angina
Patients Suppress Adverse Outcomes with Early Implementation
of the ACC and AHA Guidelines)
• Access to NCDR™ support services such as:
– Clinical/Technical Support
– Quarterly Reports
– Training and Orientation
• No Charge for Participation due to funding provided by
– Genentech
– Bristol-Myers Squibb Corporation/Sanofi Partnership
– Schering Plough Corporation
Registries Work
• QI demonstrated in NRMI and CRUSADE
outcome studies.
• Registries provide:
– reports to monitor use and outcomes of evidencebased medicine.
– benchmarking information based on standardized
definitions.
– adapt and explore new metrics in a confidential
environment.
– help clinicians to help hospitals assess quality of care.
CRUSADE
Participant Proportion of Patients Receiving 100% of
All Guidelines-Recommended Therapies
50%
46%
50%
48%
47%
36%
31%
25%
34%
33%
30%
30%
21%
16%
0%
Overall 100%
Acute 100% Correct
Discharge 100%
Correct Medication
Medication
Correct Medication
Q1
Q4
Q8
Q11
Future ACTION
• v.2.0
• Data vendor submission option
• ORYX and CMS data submission
ACTION v.2.0
Will:
• Include performance measures and quality indicators
from ACC/AHA, JCAHO/CMS, CRUSADE, NRMI
• Include quality metrics and corresponding data elements
for participant process improvement.
• Incorporate the comparison of elements and definitions
from ACC/AHA Data Standards, STS, CathPCI 4.0 and
other NCDRTM registries
• Incorporate elements from D2B Alliance (Time-toReperfusion) workgroup
Data vendor submission option
• ACTION v.2.0 will include software vendors for
data submission
• Specifications will be released and certification
of vendors will take place early 2008
ORYX and CMS data submission
• data elements are aligned with the like JCAHO
and CMS measures
• ACTION v.2.0 will incorporate data elements in
order to be aligned with CMS/JCAHO
ACTION Tool Development
•
•
•
•
Take ACTION
IC3-CAD
QI Tools
NCDR Web Based Education
How to Join
• Download the enrollment file from www.
ncdr.com
• Complete your enrollment packet and submit
the materials to the NCDR
• Receive Welcome Kit
• Complete online tool tutorial
For Additional Information
NCDR
Website:
www.ncdr.com
Service Center:
(800) 257-4737
Monday –Friday, 8:00 am – 5:00 pm ET
E-mail:
[email protected]
Fax:
(202) 375-6843
Mailing address:
2400 N Street NW
Washington, DC 20037