Welcome to the Chest Pain MI Registry's version 3.0 education. The content in this presentation was developed and provided by Shelley Conine, Kristen Young, and Denise Pond. I'm Veronica Wilson, and I'll be narrating this presentation. What's new for the Data Collection Form version 3.0 for the Chest Pain MI Registry provides our most current version of registry changes to the Data Collection Form. This Data Collection Form education will be divided into two parts, Part 1 and Part 2. This is Part 1, which focuses on Sections A through E. Please make sure you watch both parts. The objectives for this education are to outline Chest Pain MI Version 3.0 data collection options, new patient populations for inclusion, and NCDR sampling methodology for selected patient types. Identify new, revised, and retired data elements in the Chest Pain MI Registry Version 3.0, data submission options using the full or basic dataset, and impacts of datasets on Outcome Reporting and Registry Achievement Awards. Review features of the ACC Online Data Collection Tool, and approaches to reduce data abstraction burden, such as registry interoperability. To locate the Chest Pain MI Data Collection Form, please log in to the Chest Pain MI Registry at cvquality.acc.org. Click on the Chest Pain MI Registry name and find the registry homepage. Once on the homepage, please select Resources, then Documents to access the Data Collection Form. The form is located under the heading Chest Pain MI Registry Version 3.0 Documents. We will now get started with our review of the Version 3.0 Data Collection Form for the Chest Pain MI Registry. Version A represents the Demographics section of the Data Collection Tool, and it is unchanged from our previous version. The Demographics section is interoperable with other NCDR registries using the same platform. The blue dots displayed throughout this presentation represent data fields which will tentatively be interoperable with the CATH PCI Registry in the future. Please review the Interoperability Guide on the Resources page for details. Section B, Episode of Care. All new data fields to Chest Pain MI Version 3.0 will be highlighted in blue. In Version 3, the registry captures the Emergency Department and Admitting Providers. Versions 3020-3030 Research Study is a field that is used specifically for the ACC NCDR research studies. Specific study names will be given to facilities if patients are enrolled. There are no ACC NCDR-specific research studies currently. Patient refusals for medical information included in research must be specifically documented in the medical record. This data element is coded by exclusion, therefore, if it is not documented in the medical record, hospital staff do not have to ask the patient for this information. The attending provider's name and NPI number can only be added once, designated by only one space after the data element numbers. Please note, the ED providers and attending providers have multiple spaces after them, meaning more than one provider may be added for ED and admitting physicians. Section C, History and Risk Factors, has a new section for smoking. Current or recent smoker was a yes-no question in the previous registry version. Consider use of any tobacco product as equivalent to a cigarette for the reference definitions. Former in this section indicates the patient has not smoked 100 or more cigarettes during his or her lifetime. Former indicates patient has smoked at least 100 cigarettes during his or her lifetime but does not currently smoke. Current every day indicates the patient has smoked at least 100 cigarettes during his or her lifetime and still smokes regularly every day. Recent, some days, a patient has smoked at least 100 cigarettes during his or her lifetime and still regularly smokes periodically, meaning not every day, but it is consistent. Smoker current status unknown, the patient is known to have smoked at least 100 cigarettes in the past, whether they currently still smoke is unknown. And if ever smoked, the patient's current and prior smoking status is not known. When looking at this section, the reference is specifically about tobacco use, not about recreational drug use. The tobacco types and amounts are self-explanatory. Tobacco type doesn't include smokeless cigarettes. All of these definitions are located in your data dictionary. Home meds are in Section C. Please note that medications are listed alphabetically by category. The first new category is a combination medication, naprilicin inhibitor and angiotensin II receptor blocker. The next new category is oral anti-glycemic agents. The last new category is the PCSK9 inhibitors, which target and activate specific proteins in the liver called PCSK9, dramatically reducing the amount of harmful LDL cholesterol circulating in the blood. Section D is cardiac status on presentation. This section was previously cardiac status on first medical contact in the prior registry version. Patient type will be designated by the discharge diagnosis code located in the inclusion document. In addition to the pre-arrival STEMI, the chest pain in my registry will capture the in-hospital STEMI population. Please review the registry inclusion document for additional details. Cardiac arrest outside of healthcare facility provides specific data elements regarding cardiac arrest occurring outside of a healthcare facility and will include a cardiac arrest occurring upon transfer from one facility to the next. If a patient experiences cardiac arrest at a doctor's office, nursing home, or rehab center, please code no to sequence 4630. A cardiac arrest that is witnessed is one that is seen or heard by another person. Additionally, the chest pain in my registry includes the question, did the arrest occur after arrival of EMS? Was a bystander CPR performed? What was the first cardiac arrest rhythm? Was it shockable, not shockable, or unknown? What was the resuscitation date and time? Cardiac arrest at transferring healthcare facility indicates whether the patient had a cardiac arrest at the transferring healthcare facility prior to arrival at the current facility. This includes doctor's offices, nursing homes, or rehab centers. ED disposition indicates where the patient went after the emergency department and includes inpatient or observation status with the time and date the observation order was written. Section D. Risk score documented is a yes-no. If the required information is not present in the medical record, please engage your clinicians to supply the information needed. Version 3 has two risk scores which will be captured. One, TIMI, thrombolysis in myocardial infarction score. Two, GRACE, global registry of acute coronary events. These scores are linked to a quality measure. Please engage your clinicians to obtain this information. This section has two additional new data elements. Ischemic symptoms resolved before testing. Chest x-ray. Both data elements will be part of the appropriate use criteria reported in version 3. Another data element added to version 3 is non-invasive test performed. Options for coding this element are yes, no, no reason. No reason means there is no documentation stating a reason for a non-invasive test was not performed. No, medical reason means there is documentation that there is a medical reason for not performing the non-invasive test. No, patient reason means there's a patient-based reason documented in the medical record for not performing the non-invasive test. The P2Y12 inhibitors are the only arrival medications which require the dose date and time. The thrombolytics section has been minimized and replaces the previous version data element reason thrombolytics not administered. It uses the new format for coding medications which will be reviewed in the discharge section. EMS has its own section now, and EMS STEMI activation alert is new. EMS STEMI activation alert is completed only for pre-arrival STEMI patients and the target value is EMS first medical contact to arrival. This is the first of two opportunities to capture the activation of the cardiac cath lab for STEMI. Section E, Arrival Information, formerly admission in the prior registry version, has a new data element named an ID for transferring facility unavailable. The addition of unavailable is for international sites and for those rare occasions where the ID number of a facility from which the patient was transferred is not available. An example would be a new facility whose ID number is not listed yet in the American Hospital Association listing that's released annually. This concludes Version 3 Data Collection Form Education Part 1 of 2.

Data Collection Form

Chest Pain MI Registry

updates and changes

patient populations

data elements