Welcome to the Chesapeake and Miami Registries 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 Chesapeake and Miami 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 2, which focuses on Sections F through J. Please make sure you watch both parts. The objectives for this education are to outline Chesapeake and Miami Registry 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 Chesapeake and Miami 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 Chesapeake and Miami Data Collection Form, please log on to the Chesapeake and Miami Registry at cvquality.acc.org. Click on the Chesapeake and Miami 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 Chesapeake and Miami Registry Version 3.0 Documents. We will now get started with our continued review of the Version 3.0 Data Collection Form for the Chesapeake and Miami Registry. The troponin counter, sequence 12255, allows values to be added sequentially. A peak troponin value is not determined by the abstractor. The values are entered as Lab or Point of Care. The dynamic list will be displayed, allowing the abstractor to select the troponin assay with the upper reference limit. Only lab-resulted values will apply to inclusion in the registry for STEMI and NSTEMI patients. Section F, Labs. All lipids are captured independently and there are no child fields. Section G, Procedure Information, has new selection options for coronary angiography. Please answer this as follows. No, no reason indicates no documented reason why angiography was not performed. No, medical reason indicates clear documentation of a reason related to the patient's medical issue or concern. No, patient reason indicates a clearly documented reason related to a patient reason. No, system reason indicates that cath lab equipment is down, for example. Native vessels with stenosis include stenosis of any native vessels that are greater than or equal to 50%. Coronary angiography now seeks to capture native and graft vessel with stenosis greater than or equal to 50% in vessels greater than or equal to 2 millimeters. Please code disease found in vessels less than 2 millimeters when PCI is intended for the lesion and or the patient's anatomy is less than 2 millimeters. In instances where multiple lesions are present in one segment, enter the single highest percent stenosis noted. It is acceptable to use prior cath lab visit information if there have been no changes in coronary anatomy. This includes stenosis determined via cardiac catheterization at another facility as the target value is the last value between 6 months prior to current procedure and current procedure. Version 3 provides a coronary artery segment diagram to assist you in locating the appropriate arteries. To demonstrate an example, documentation of an LED lesion should be coded as segment 12. This coronary segment diagram document is in the resource section. Find it by clicking resources and documents and navigate to the version 3.0 documents. For PCI indications, we have added two new data elements. STEMI stable than less than or equal to 12 hours indicates there are no symptoms of recurrent or persistent ischemia, symptoms, heart failure, or electrical instability occurring less than or equal to 12 hours from symptom onset. New onset angina indicates the PCI is performed for the patient's new onset angina, whether it's typical or atypical angina that developed within the previous two months. Both indications are defined in the data dictionary. Reason primary PCI not performed has two reasons listed. No, no reason means that there is not a documented reason related to the patient's medical issue or medical concern regarding why the primary PCI was not performed. No, medical reason means there is a medical reason documented related to the patient's medical issue or medical concern. The performance measure will use no medical reason for exclusions in the measure. Section H, PCI procedure, complete this section for primary PCI for acute STEMI occurrences only. Cath lab activation has changed to capture only those activations that occur after arrival. Therefore, the target value is arrival at this facility to the current procedure. Cath lab activation canceled has been added and patient-centered reason for delay is now a yes or no element. We now capture emergent placement of LV support, which was previously captured under other. PCI procedure medications are listed by category located under the PCI section and dosing has been removed. Currently, the heparin derivative is for international sites only as this medication has not been approved for use in the United States. Section H provides a new way to capture episode events, which are listed alphabetically. Multiple events can be added if they occur more than once as identified by the date and time that each event occurred. There are specific definitions for each event occurring in each episode located in the events section of the data dictionary. Section H also has other events. New to version 3 is NSAIDs administered as part of the 2017 performance measure. This edition is represented as quality measure number 5 and it tracks NSAIDs administered during the current episode of care, administered during hospitalization. Version 3 has a new hypothermia date and time required. This whole section is required for all cardiac arrests that occur. Please leave the section blank for all other events that occurred. Version 3 has added level of consciousness, LOC, and all the associated selection definitions are available in the version 3 data dictionary. Section J includes a new discharge time, which is required for the performance measure. Type of clinical trial has also been added, which requires the abstractor to select all that apply. Section J hospice care requires a date and time in version 3. New in version 3.0, cause of death, now requires a specific reason to be coded. This information should be in the death certificate. Section J discharge medications. The medication doses are only required for aspirin and statin. Regarding aspirin, the registry needs to know if there is a low dose given, which is 75 to 100 milligrams, or if the dose is high, which is greater than 100 milligrams. Non-statin includes PCSK9 inhibitors. Statins will be low dose, moderate dose, and high dose. Please refer to the data dictionary for a comprehensive list of all medication dosing. Discharge medications have specific indications for coding. Yes indicates the medication was prescribed post-procedure and for discharge. No, no reason indicates there is no documentation stating a reason for the medication not being prescribed. No, medical reason indicates a specific reason related to a medical issue or concern for not prescribing the medication. No, patient reason indicates a reason documented based on patient preference. Please refer to the data dictionary for the complete definitions for all data elements. This concludes Version 3 Data Collection Form Education, Part 2 of 2.

Data Collection Form Version 3.0

registries

data elements

outcome reporting

discharge medications