development of a nationwide ambulatory cardiovascular registry: an update on pinnacle-af

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A414 JACC April 1, 2014 Volume 63, Issue 12 Arrhythmias and Clinical EP DEVELOPMENT OF A NATIONWIDE AMBULATORY CARDIOVASCULAR REGISTRY: AN UPDATE ON PINNACLE-AF Poster Contributions Hall C Sunday, March 30, 2014, 3:45 p.m.-4:30 p.m. Session Title: Arrhythmias and Clinical EP: New Observations Affecting Clinical Management Abstract Category: 4. Arrhythmias and Clinical EP: AF/SVT Presentation Number: 1217-101 Authors: Brendan Mullen, William Oetgen, Samantha Risch, Nathan Glusenkamp, American College of Cardiology, Washington DC, DC, USA Introduction: In 2012 the PINNACLE Registry expanded its focus on AF, requiring 100 additional data elements. Cardiologist participation in expanded data collection realistically requires minimal workflow disruption. Reducing disruption requires sourcing data from heterogeneous HIT systems which have the potential to result in poor data quality. Resolving this pragmatism paradox is the key challenge to operating ambulatory registries at scale. Methods: We solved this challenge by designing a technology platform that integrates with 27 different EMRs. The interface uses proprietary maps of EMRs combined with custom coding developed in collaboration with each practice to normalize source data to the PINNACLE schema without requiring supplemental data collection. Practices occasionally support modest workflow changes to improve data capture for accurate quality reporting and earning Federal PQRS bonuses. Results: The PINNACLE Registry methods have resulted in substantial growth in patients, encounters, data submitters, and research (Table 1). Conclusion: While far from perfect, our methods establish that PINNACLE can resolve the pragmatism paradox and meet its quality improvement and research objectives at scale. We maintain the ability to analyze data across a multiyear longitudinal history as well as to consume and report on new clinical data. This work supports the long-term vision of creating clinical research systems capable of operating at the scale and speed of real world clinical practice.

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A414JACC April 1, 2014

Volume 63, Issue 12

Arrhythmias and Clinical EP

dEVELopmEnt of a nationwidE ambuLatory cardioVascuLar rEgistry: an updatE on pinnacLE-af

Poster ContributionsHall CSunday, March 30, 2014, 3:45 p.m.-4:30 p.m.

Session Title: Arrhythmias and Clinical EP: New Observations Affecting Clinical ManagementAbstract Category: 4. Arrhythmias and Clinical EP: AF/SVTPresentation Number: 1217-101

Authors: Brendan Mullen, William Oetgen, Samantha Risch, Nathan Glusenkamp, American College of Cardiology, Washington DC, DC, USA

introduction: In 2012 the PINNACLE Registry expanded its focus on AF, requiring 100 additional data elements. Cardiologist participation in expanded data collection realistically requires minimal workflow disruption. Reducing disruption requires sourcing data from heterogeneous HIT systems which have the potential to result in poor data quality. Resolving this pragmatism paradox is the key challenge to operating ambulatory registries at scale.

methods: We solved this challenge by designing a technology platform that integrates with 27 different EMRs. The interface uses proprietary maps of EMRs combined with custom coding developed in collaboration with each practice to normalize source data to the PINNACLE schema without requiring supplemental data collection. Practices occasionally support modest workflow changes to improve data capture for accurate quality reporting and earning Federal PQRS bonuses.

results: The PINNACLE Registry methods have resulted in substantial growth in patients, encounters, data submitters, and research (Table 1).

conclusion: While far from perfect, our methods establish that PINNACLE can resolve the pragmatism paradox and meet its quality improvement and research objectives at scale. We maintain the ability to analyze data across a multiyear longitudinal history as well as to consume and report on new clinical data. This work supports the long-term vision of creating clinical research systems capable of operating at the scale and speed of real world clinical practice.