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Cardiology
Electronic Catheterization Records and Data Collection for Quality Improvement
Built from Cardiovascular Catheterization and Intervention: A Textbook of Coronary, Peripheral, and Structural Heart Disease
What’s inside
7 sections · 89 slides
Overview
- Scope of this presentation
Electronic data in the catheterization laboratory
- Role of electronic data systems
- Origins of the cardiovascular information system
- HITECH Act and EHR adoption
- Cardiac catheterization laboratory in use
- Primary sources of electronic cath lab data
- Sources and outputs for electronic records in the catheterization laboratory
- Integration into a single data source
- Data quality as a shared responsibility
- Uses of structured data at two levels
- Uses of Structured Electronic Catheterization Laboratory Data for Quality Improvement
Core data elements for procedural reporting
- Guiding principles for structured reporting
- National Cardiovascular Research Infrastructure project
- 2014 Health Policy Statement on structured reporting
- NCDR and the CathPCI data dictionary
- The PCI status variable
- Information lost in categorisation
- Intracoronary imaging as a blind spot
- Coronary angiography during percutaneous intervention
- Wider benefits of standardised records
Structural requirements for electronic data capture
- Shared responsibility for data entry
- Registration, scheduling and the electronic health record
- Haemodynamic and procedural reporting systems
- Clinical data abstraction
- Allocating data capture by role
- Sequence of data capture around a case
National and regional quality improvement
- The ACCF registry suite
- TVT registry participation and CMS coverage
- State and regional consortia
- Registries outside the United States
- How registries are intended to improve care
- Content of registry feedback reports
- What makes audit and feedback effective
- Pci Quality Indicators Reported with Benchmarking and Performance Goals to Hospitals Participating in the Cardiac Coap Collaborative
- Risk adjustment of procedural outcomes
- Consequences of incomplete case-mix adjustment
- Aims of public reporting
- Evidence of benefit from public reporting
- Risk-averse case selection under public reporting
- Physician mistrust and reform of public reporting
- Collaborative interventions and time to reperfusion
- Standardised time measures as the enabling step
- Reported effects of Mission: Lifeline
- Door-to-balloon time in pay-for-performance
- The BMC2 collaborative model in Michigan
- Michigan compared with New York
- Research uses of catheterization laboratory data
Local and hospital-based quality improvement
- Standing of local quality improvement
- The continuous quality improvement model
- Four stages of the CQI cycle
- How structured data make CQI more efficient
- Arterial access route in cardiac catheterization
- Case study: a radial-first bleeding reduction programme
- Morbidity and mortality conference in the cath lab
- How electronic records support M&M conference
- Peer review and competency assessment
- Separation of quality assurance from quality improvement
- Point-of-care decision support
- Barriers to point-of-care decision support
- Current state of bedside risk prediction
- Promoting accurate documentation
The Clinical Assessment, Reporting and Tracking programme
- Scope of the CART programme
- Downstream applications of CART data
- Flow of electronic catheterization laboratory data in the Veterans Affairs system
- CART pre-procedure data capture
- CART post-procedure data capture
- User interface of the Veterans Affairs quality and safety reporting application
- Real-time clinician entry: advantages and costs
- CART reporting and benchmarking
- National adjudication of major adverse events
- Analytics embedded in the CART application
- Coronary stent deployment
- Challenges and future directions
- Summary
- Points to carry forward
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Cardiovascular Catheterization and Intervention: A Textbook of Coronary, Peripheral, and Structural Heart Disease
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