Welcome to the Chest Pain MI Registry's Version 3 Education. The content in this presentation was developed and provided by Shelley Conine, Kristen Young, and Denise Pond. I am Kate Malish, and I will be narrating this presentation. This education will describe the most current inclusion criteria for the Chest Pain MI Registry Version 3. This inclusion criteria education is condensed into one presentation, however, it is important to review the other Version 3 education focused on the Data Collection Tool and the Data Collection Form. The objectives for Version 3 education are to outline Chest Pain MI Version 3 data collection options, new patient populations for inclusion, and NCDR sampling methodology for selected patient types. Identify new, revised, and retired data elements in Chest Pain MI Registry Version 3 data submission options using the full or basic dataset, and impacts of datasets on outcome reporting and registry achievement awards. Explain features of ACC Online Data Collection Tool and approaches to reduce data abstraction burden such as registry interoperability. To locate the Chest Pain MI Inclusion Document, log on to the Chest Pain MI Registry at cvquality.acc.org. Click on the Chest Pain MI Registry logo and find the Registry homepage. Once on the homepage, select Resources, then Documents. Data Collection Options. There are two datasets available for Version 3. With the full dataset, it is important to note that all data elements applicable to the episode are collected. The full dataset provides comprehensive data to support reporting of performance measures, appropriate use criteria, risk-adjusted outcomes, and post-discharge metrics. In the basic dataset, select data elements applicable to the episode record are collected. The basic dataset provides a smaller number of data elements, slightly more than half of those in the full dataset, to support hospitals who are beginning quality and system improvement efforts. At the bottom of the data collection form is a key to alert users which data elements are collected for sites submitting the basic dataset. The yellow highlighted data elements are captured when submitting the basic dataset. All applicable data elements are captured when submitting the full dataset. How does Version 3 compare to the previous version by names and numbers? Let's look. Notice there are 78 fewer data elements to abstract for the full dataset in Version 3. Follow-up elements are part of full-set data, but there are no constraints defined to restrict any participants from submitting follow-up. Follow-up elements are currently optional. A site participating using the basic dataset, or BDS, is still able to send follow-up records. Every facility has the option to participate in either the full dataset, or FDS, or the basic dataset, BDS. Once a facility has determined which dataset is right for them, the Facility Registry Site Manager, or RSM, will confirm the choice by designating the submission type in the Registry Site Profile. To navigate to the Site Profile, log into the ChessPain MI Registry and navigate to the Administration tab at the left navigation bar and select Site Profile. Once on the Site Profile, the Registry Site Manager will designate the full dataset, or the basic dataset, and once selected will click the blue Submit button to complete the dataset designation. If a facility chooses to submit the basic dataset, the facility must designate a plan to submit all AMI patients or STEMI-only patient types, which now includes in-hospital STEMI. What is sampling? Sampling is the process of selecting a representative portion of the population or populations of interest to estimate the hospital's overall performance. Record records are consecutively selected based on discharge date until the minimum record count is achieved. Consecutive is defined as records following one another in an uninterrupted succession or order specifically by discharge date. When sampling, additional records beyond the required total episode record count for the quarter may be entered. The Chest Pain MI Registry is the first and only registry in the NCDR to offer sampling. The populations are further defined in the patient selection criteria in the upcoming section. There is no requirement that a hospital submit 100% of their low-risk chest pain and unstable angina patients, as these populations are generally high-volume. The Inclusion Guide contains details on the methodology for sampling as well as information on how to identify patient records for the selection using ICD-10 code criteria. For chest pain center accreditation customers, please note that the NCDR will not be performing randomization of your patient records. Also note the low-risk of chest pain patients and the unstable angina patients are available for sampling. The minimum number of records per month for low-risk chest pain is 30 records, making it 90 records per quarter. The minimum number of records per month for unstable angina is 10 records, making it 30 records per quarter. These numbers are sampling minimum requirements. During the data submission process, all facilities must identify if they have provided a sample patient population. To perform this requirement, navigate to the Submit to DQR page by clicking Data at the left navigation bar. Once here, click Submit to DQR at the left navigation bar. This is the appropriate place to submit your data and indicate sampling all at the same time. First, select the time frame of the data being submitted. In this example, we have selected 2018 Quarter 3. Next, click the sampling questions as Yes or No. Select No if all patient records eligible for registry inclusion are being submitted. Select Yes when a sample of patient records eligible for registry inclusion are being submitted for low-risk chest pain or unstable angina. Finally, identify each sampling patient population type where only a sample of records are being submitted. Patient Selection Criteria is now looking at required STEMI patients and includes both pre-hospital and in-hospital STEMI patient populations. The Patient Selection Criteria is also looking at required and STEMI patients with the exception for sites that are submitting using the basic dataset and have indicated they are only choosing to collect information on STEMIs only. Low-risk and unstable patient types are optional for the Chest Pain MI Registry. These patient types are available to support ACC Accreditation Chest Pain Center customers also participating in the Chest Pain MI Registry. The fourth universal definition of acute MI is defined by the detection of a rise and or fall of lab-resulted cardiac biomarkers, preferably cardiac troponin levels, with at least one value above the 99th percentile upper reference level limit and with at least one of the following. Symptoms of ischemia, new or presumed new significant ST-segment T-wave changes or new left bundle branch block. ICD-10 codes are provided for retrospective identification of medical records only and do not replace clinical review and evaluation of eligibility for inclusion in Chest Pain MI Registry. The Chest Pain MI Registry is designed to provide participating centers feedback on the care and outcome of patients with cardiac symptoms and acute myocardial infarction. The registry accepts four cardiac classifications identified as the following patient types, patients 12-360, low-risk chest pain, unstable angina, NSTEMI, and STEMI. The two data collection options for Chest Pain MI Registry facilities provide different benefits. The basic dataset supports outcome reporting, including risk-standardized outcomes and clinical data reporting requirements for chest pain center accreditation. Basic dataset facilities are eligible for the Registry's Performance Achievement Award Program, however, are only eligible to achieve the highest level status of GOLD. The full dataset provides data for Appropriate Use Criteria, or AUC, reporting on cardiovascular imaging for ED patients with chest pain. In addition, the facility will receive a full risk-standardized outcomes report. A facility selecting the full dataset facility is eligible for the Registry's Performance Achievement Award Program at the highest level of Platinum. This concludes Inclusion Criteria for the Chest Pain MI Registry Version 3.

Chest Pain MI Registry Version 3

data collection options

patient populations

sampling methodology

Performance Achievement Award Program