3/8/2014 1 ACTION Registry ACTION Registry ACTION Registry ACTION Registry – GWTG GWTG GWTG GWTG Version 2.4 Version 2.4 Version 2.4 Version 2.4 Dr. Joanne Foody Kim Hustler The following relationships exist: Dr. Foody:Janssen, Sanofi, Genzyme, Aegerion, Amarin, BristolMeyersSquibb, Abbott, Gilead, ACC, Pfizer, Merck Kim Hustler: No Disclosures Session Objectives • Outline the data points that will be changing for ACTION Registry – GWTG Version 2.4 • Discuss the rationale and implications for the changes in the data elements
24
Embed
ACTION Registry ACTION Registry ––––GWTG GWTG Version 2 · for ACTION Registry –GWTG Version 2.4 • Discuss the rationale and implications for ... • Dr. Mauro Moscucci
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Who Who Who Who did we include in the process of did we include in the process of did we include in the process of did we include in the process of
determining what fields to adddetermining what fields to adddetermining what fields to adddetermining what fields to add????
1. Email suggestions
2. RSM calls
3. Focused RSM teleconferences
4. Physician committee meetings
5. All of the above
3/8/2014
3
ARS Question #2
How did we determine what fields to remove?How did we determine what fields to remove?How did we determine what fields to remove?How did we determine what fields to remove?
1. Frequency of fields being answered
2. Current practice
3. Core data elements
4. Enough data already captured
5. All of the above
ACTION -GWTG Q.I.
Subcommittee Members
• Dr. Joanne Foody – Chair
• Dr. Karen Alexander
• Dr. Donald Casey
• Dr. Shahriar Dadkhah
• Dr William French
• Dr. Michael Ho
• Dr. Mauro Moscucci
• Dr. Gregg Fonarow
• Dr. Judith Lichtman
• Dr. Nurcan Illksoy
• Dr. James Jollis
• Dr. Mikhail Kosiborod
Process
• SQOC – Science & Quality Oversight
Committee
• ACTION Registry – GWTG Steering
Committee
• Stakeholder feedback
• NCDR Management Board
•
3/8/2014
4
Registry Site Manager Calls
• Calls were specifically to obtain feedback
from users
• Two Teleconferences
�September 27, 2011
�October 6, 2011
Be Careful What
You Ask For!
Version 2.4 Changes
New therapies/medicationsNew therapies/medicationsNew therapies/medicationsNew therapies/medications
How will How will How will How will you enter you enter you enter you enter the Xarelto in the data the Xarelto in the data the Xarelto in the data the Xarelto in the data
Excessive dosing UFH- no PCIThe data collection form would be completed as:
• Reperfusion Candidate #8000 “yes”
• Primary PCI #8015 “no” Reason no PCI #8030- Anatomy
not suitable to primary PCI
• Thrombolytic “no”, reason #8035- Expected DTB <90 min- if
was expected
3/8/2014
9
ARS Question # 4
Would this patient be included in the UFH Would this patient be included in the UFH Would this patient be included in the UFH Would this patient be included in the UFH
Excessive dosing report as we are currently Excessive dosing report as we are currently Excessive dosing report as we are currently Excessive dosing report as we are currently
entering itentering itentering itentering it????
1. No
2. Yes
Answer: #1 (No)
• As of October 1, 2013 discharges “Diagnostic
Angiography Time” Seq. #7022 is the identifying
time for UFH doses administered in the cath lab
• If date/time of UFH Seq. #6852/6853 is prior to prior to prior to prior to
Angiography time, it is included
• If afterafterafterafter Angiography time- dose is excluded
• 5000 U IV bolus in cath lab administered at 08:15
3/8/2014
10
ARS Question # 5
Would this patient be included in the UFH Would this patient be included in the UFH Would this patient be included in the UFH Would this patient be included in the UFH
Excessive dosing report as we are currently Excessive dosing report as we are currently Excessive dosing report as we are currently Excessive dosing report as we are currently
entering itentering itentering itentering it????
1. No
2. Yes
V2.4 Excessive dose UFH • V2.4 will capture date/time for both initial doses (bolus &
infusion)
• The dates/times provide verification of administration prior
to or after arrival in cath lab
• Patient can only ‘fail’ the Excessive Dosing metric once
What would you select for PCI Indication?What would you select for PCI Indication?What would you select for PCI Indication?What would you select for PCI Indication?
1.1.1.1. Primary PCI for STEMIPrimary PCI for STEMIPrimary PCI for STEMIPrimary PCI for STEMI
2.2.2.2. PCI for STEMI (unstable, >12 PCI for STEMI (unstable, >12 PCI for STEMI (unstable, >12 PCI for STEMI (unstable, >12 hrhrhrhr from from from from sxsxsxsx onset)onset)onset)onset)
3.3.3.3. PCI for STEMI PCI for STEMI PCI for STEMI PCI for STEMI (stable(stable(stable(stable, >12 , >12 , >12 , >12 hrhrhrhr from from from from sxsxsxsx onsetonsetonsetonset))))
How How How How would you would you would you would you answer Hispanic or Latino answer Hispanic or Latino answer Hispanic or Latino answer Hispanic or Latino
Collaborative/Integrated CareCollaborative/Integrated CareCollaborative/Integrated CareCollaborative/Integrated Care
• Two FMC fields to capture non-EMS FMC
• Non-system reason for delay for First
Medical Contact
• Additional EMS fields & cath lab activation
Two FMC fields to capture nonTwo FMC fields to capture nonTwo FMC fields to capture nonTwo FMC fields to capture non----EMS FMCEMS FMCEMS FMCEMS FMC
NonNonNonNon----system system system system reason for delay for First Medical reason for delay for First Medical reason for delay for First Medical reason for delay for First Medical
• Presented to physician office at 11:30 with 2 hours
of epigastric pain, and pain radiating down left arm
• ECG- STEMI
• EMS patient contact time 11:50- transported by
ambulance to PCI hospital
• Immediate Primary PCI
ARS Question # 9
What time would you enter in for First What time would you enter in for First What time would you enter in for First What time would you enter in for First
Medical Contact time Seq. #3106?Medical Contact time Seq. #3106?Medical Contact time Seq. #3106?Medical Contact time Seq. #3106?
1. 11:30 Physician Office contact time
2. 11:50 EMS contact time
3. Leave time blank
3/8/2014
18
Data Collection FormStarting with January 1, 2014 discharges
Enter into Auxiliary field 4 the response to question:
Was EMS the first medical contact?
Data Collection ToolEnter “Y” or “N” into Auxiliary field 4 under Discharge
• Transported to hospital- presented in cardiac arrest
at 11:05
• Coded for 10 minutes-resuscitated
• ECG- at 11:20- STEMI
• Immediate Primary PCI
3/8/2014
20
ARS Question # 10
How is the ECG captured currently?How is the ECG captured currently?How is the ECG captured currently?How is the ECG captured currently?
1. 1st ECG in metric denominator/”no”
numerator
2. Subsequent ECG- excluded
3. Excluded for non-system reason for delay
Version 2.4 Changes
Geographic concerns with DGeographic concerns with DGeographic concerns with DGeographic concerns with D2222B patientsB patientsB patientsB patients
Version 2.4 Changes
Initial Initial Initial Initial & peak or lowest lab values same & peak or lowest lab values same & peak or lowest lab values same & peak or lowest lab values same ----
check boxcheck boxcheck boxcheck box
3/8/2014
21
Version 2.4 Changes
Troponin & CKTroponin & CKTroponin & CKTroponin & CK----MB MB MB MB initial initial initial initial and and and and peak peak peak peak –––– date/time date/time date/time date/time