AACVPR Outpatient Cardiac Rehabilitation Registry Enhancements – Now Live!

Published December 11, 2013

What the Enhancements Mean for Your Program

Track Patients Who Are Referred But Don’t Enroll

In the enhancements, we’ve included a field for the enrollment status of the patient. If the patient was referred but did not enroll, you can choose an option from the Reason for Not Enrolling list to describe why the patient did not enroll.

Your program’s enrollment rate can be an important quality/performance metric. In order to track this metric accurately, you’ll need to enter every patient for which your program receives a physician referral. Once you’ve determined a patient is not going to enroll in the program, you should enter his/her Enrolled status as No and enter a primary reason describing why he/she did not start. Also enter as much demographic, medical history, and clinical data you have on these patients, either from their referral forms or their medical records, as this data may help you understand what types of patients are less likely to enroll in cardiac rehabilitation (CR) and how to improve overall enrollment.

Adapting to the American College of Cardiology/American Heart Association Cholesterol Management Guidelines

The release of the new ACC/AHA guidelines was a surprise. While we have added some features to reflect these guidelines, we have also kept the “old” ATP III target levels in place while users acquaint themselves with the new recommendations.

The registry enhancements include a new option list for the Statin/Prescribed section of the Medications page. You will now be able to select one of the following options:

  • Yes-High Intensity
  • Yes-Moderate Intensity
  • Yes-Low Intensity
  • Yes-Intensity Not Indicated
  • No
  • No-Exclusion
  • Unknown

The “intensity modifiers” are based on the new guidelines. Several new resources are available in the Registry to assist you in determining the intensity level, including a table on the new and improved Data Sheet and a separate “Resource for Statin Therapy” document. We’ve also added a line in our new Performance Report (see below) to reflect the percentage of appropriate patients who are prescribed high-intensity statin therapy.

New Performance Report

The new Performance Report is the flagship of the registry’s reporting features. The Performance Report displays quarterly results of how your program stacks up in several secondary prevention measures as compared to programs in your state, programs of like-size, or the entire registry. You’ll be able to see the percentage of patients meeting nationally recognized goals and where your outcomes rank within the comparison group. You’ll also see your “Completion Index,” an indicator of how complete your patient records are when calculating the performance measure. This report will be a valuable tool in helping you monitor your program’s outcomes for quality assurance.

Additional Reporting Enhancements

We made improvements to the formatting of each report in the Registry and have provided an option to download the report as an Adobe PDF document for you to print or save.

You’ll also notice changes to the Individual Patient Report. We have listened to users’ suggestions and incorporated new methods for showing change over time and if a patient is meeting a prevention target. You can turn these features on or off to better display improvements the patient has made.

The Program Outcomes and Comparison Reports have also been improved for better readability.

In all, we’ve made improvements to the reports that will allow you to easily understand the information provided and to better monitor your patients’ outcomes and your program’s performance.

We’ve also created a Snapshot Stats section on your program’s registry home page. Snapshot Stats allows you to quickly see selected demographic and clinical statistics from your patient population.

New, Improved “Data Mining”

In addition to the Advanced Data Extraction utility, the registry now includes a quicker way for you to selectively filter the set of patient records to be extracted. This new data extraction method starts by allowing you to download your entire dataset. You may then filter the list by adding filter criteria one at a time to obtain only the patient records you are interested in reviewing. Unlike the Advanced Data Extraction method, this type of extraction will always present the complete data record – all data fields – for the patients in your filter criteria. Once you’ve created your query, you can download the data in an Excel file to perform further analysis.

For more detail, please reference the Registry User Guide.

Dietary Outcomes

We’ve replaced the fields for dietary saturated fat and fruit/vegetable servings with score fields for four commonly used dietary assessment tools: The Diet Habit Survey, MEDFICTS, Rate-Your-Plate (HEART version), and the Block Dietary Fat Screener. Resources for these instruments are available on the AACVPR CR Registry resource page.

Additional Registry Enhancements

While the complete list of enhancements we’ve made to the registry is too long to list here, other significant ones include:

  • A consistent theme throughout the registry pages and quicker tabbing through the fields on each page
  • Unused dietary and psychological assessment sections can be closed to improve clarity of the page and only open if there are scores entered
  • Addition of new choices for Unexpected Events and Hospital Admissions based on user input
  • A new “ED Visits” section where you can document patient visits to the emergency room
  • A new “Significant Past CV History” section where you can document past cardiovascular events or procedures, such as prior CABG, prior MI, history of chronic atrial fibrillation, or ICD implant

Updated Resources to Learn More

  • Review the updated “Definitions and Comments for Selected Data Elements” for new fields and explanations.
  • The updated “Descriptions of Health Conditions for Charlson Comorbidities Based on ICD-9 Codes” document will assist users in selecting appropriate comorbid conditions.
  • The new and improved Data Sheet now more accurately follows the website interface data entry flow.
  • The “Resource for Statin Therapy” will assist you in determining the intensity level for the Statin/Prescribed section within Medications.

All of these documents can be found on the Cardiac Rehab Registry User Resources page.