Welcome Mid-Atlantic Data Managers (MACDM) 2017 Fall Meeting - - PowerPoint PPT Presentation

Welcome Mid-Atlantic Data Managers (MACDM) 2017 Fall Meeting – Tuesday, November 14, 2017

Thanks to our host Lehigh Valley Hospital – Cedar Crest

House Keeping

• Rest rooms
• Breakfast
• Lunch and snacks
• Silence all smart/flip phones/electronic devices
• Sign in and take name tags/lanyard
• Review and update the data managers listing
• Drop name tags/lanyard in container in rear of room when leaving for

the day

Agenda Review

Start Time End Time Item Presenter 8:00 am 8:30 am Sign-in, *coffee/tee/water, networking All 8:30 am 8:35 am Agenda Review All 8:35 am 8:45 am Attendees Introduction All 8:45 am 8:55 am STS Annual Data Managers Conference David Carey 8:55 am 9:10 am STS Dashboard Reporting David Carey 9:10 am 9:25 am STS Thoracic – Public reporting, 5-year follow-up, new thoracic version 2.4 form Sarah Knorr 9:25 am 10:00 am STS Cardiac – New real-time data submission, 30-day post op surgery status 2% rule, new form version 2.9 David Carey 10:00 am 10:15 am Break All 10:15 am 10:30 am Delaware Valley STS Adult Cardiac Regional Group Update Candace Trace 10:30 am 11:40 am STS Cardiac Continued, Isolated CABG Prolonged Vent Discussion All 11:40 am 12:00 pm Break – Group Photo All 12:00 pm 12:30 pm *Lunch All 12:30 pm 1:00 pm Watchman Presentation (Boston Scientific) Joe Whitaker 1:00 pm 1:45 pm Get with The Guidelines Overview (American Heart Association) Alex Kuhn, Tawny Jackson, Chrystal Glodek 1:45 pm 2:00 pm MACDM Introduction and Updates David Carey 2:00 pm 2:15 pm Break All 2:15 pm 2:30 pm ACTION – What is changing (NCDR (National Cardiovascular Data Registry)) Beth Pruski 2:30 pm 2:45 pm Cath/PCI – New Cath/PCI version 5 (NCDR (National Cardiovascular Data Registry)) Connie Anderson 2:45 pm 2:55 pm Cath/PCI Continued Discussion David Carey 2:55 pm 3:00 pm Closing David Carey

Attendees In Introduction

Around the room introduction (hint, read off your name tag):

• First name
• Last name
• Hospital, organization or retired status
• City
• State
• *Let us know if this is your first regional data managers meeting!

STS Annual Data Managers Conference

Over 500 in attendance

STS Conference (c (continued)

STS Conference Networking

Liz Watkins Contracts Manager The Society of Thoracic Surgeons Joan McKenna Northeast Account Executive Lumedx Corporation

STS Conference (c (continued)

STS Conference (c (continued)

STS 2018 Data Managers Conference

STS Conference (c (continued)

STS Dashboard Reporting

Projected Live Dates:

• Adult Cardiac Dashboard Reporting –

November 10th

• Surgeon Level Composite Ratings –

November 24th

• Thoracic Dashboard Reporting –

1st half 2018

• Congenital Dashboard Reporting –

1st half 2018

STS Dashboard Reporting (c (continued)

• Reporting refreshed nightly
• Access to patient level data from

reports (HIPPA - patient ID and record ID)

• Access to surgeon level data from

reports

STS Dashboard Reporting (c (continued)

Dashboard Reporting Access

• Only one Primary Data/File Contact

person from each hospital will have access – Will be able to see all reporting and patient levels (includes each surgeon level)

• Surgeons – Will be able to only see

their participants and their surgeon information

STS Thoracic

Lobectomy for Lung Cancer – Public reporting started 2017

• Star Rating Lung Resection Comparison
• Most current 3 years of data

Esophageal CA Resection Will Begin Public Reporting Next Summer (probably)

• Will need to average 5 resections a year
• STS says only about 50% of participants will receive a rating.

5 Year Follow-up

• 5 year follow-up on only Lung Cancer and Esophageal Cancer patients – Starting from 1-1-2015 procedures
• STS Susan Becker’s response to question on the 5-year follow up on Lung CA and Esophageal CA required or optional :

“The follow up is mandatory for Lung CA and Esophageal CA patients but can be completed for other patients is desired. If the field is not completed currently there are no repercussions. You will still get a star rating.”

• Follow-up will cover from 1-1-2015 to current harvest ending procedure (each year will start with 2015 until 2020).
• Suggestion - Reach out to your COC (tumor or cancel registry) to get your follow-up update electronically
• Pull this data the 1st quarter of each year starting in 2017.
• Once a year send an Excel file with MRN to get a follow-up date and mortality date (status (alive/deceased) can be

determined from mortality date).

• Per STS, long term follow-up data should be updated/reported with each harvest.

STS Thoracic

New thoracic version 2.4 proposed live date 7-1-2018.

• New form on our MACDM.org website under this meeting.
• New Focus/Narrowing Breadth of Cases
• Analyzed procedure for is required for all suspectedor diagnosedLung and Esophageal Cancer Resections.
• Completion of the Thymus/Mediastinal Mass, Tracheal Resection and Hiatal Hernia/GERD sections is optional.
• Many Procedures will not be analyzed any longer (e.g. decortications, pleurectomy, lung transplants, etc.)
• Now all Wedge Resections that are done for a suspected or diagnosed Lung Cancer will be considered therapeutic and entered as an

analyzed procedure

• Additional Elements added to Pre-op Section (CHF, MI, Afib, CHF, Vascular History, More detailed CT surgery history, Narcotic/Alcohol

Abuse, etc.)

• ECOG score will replace Zubrod.
• Per STS, the data managers handbook for the new form should be available in June 2018.
• 8th Edition of the Classification of Lung CA begins January 2018. New Form address these changes, but the STS did not

have an answer in how to handle the new staging categories on the current form.

STS Adult Cardiac

• Real Time Data Submission – Similar to NCDR PCI/ACTION/ICD submission and dashboard reporting
• New data submission near real time entry process. No sweat, can use same old process going forward and start this

new process at any time.

• Can submit data for past/present quarter/real time.
• If a hospital has 30 day post-op surgery status of more than 2% missing/Unknown of eligible patients, that hospital will

NOT receive a star ratings for that reporting period.

• Adult Cardiac Surgery Database Data Collection form Version 2.9 live for all 7-1-2017 and future procedures.
• Some form changes and points:
• 400 new fields
• 100 removed fields
• Page 2 - Liver Disease Child-Pugh Class
• Page 3 - Six minute walk test done, total distance walked
• Page 8 - STS Risk Calculator score was discussed with patient/family prior to surgery

STS Adult Cardiac (c (continued)

• Version 2.9 Training Manual and Updated Surgeon

Worksheets available on STS website

• Surgeon Worksheets and Risk Models Variable Chart

is on the new STS.org website: Goto (Registry and Research Center, Adult Cardiac Surgery Database, Access Data Collection Resources, Version 2.9 (all documents listed for downloading))

• STS still mystified there is little surgeon involvement.

If you can read and extract your data with little or no missing fields, then check surgeon involvement. STS will be sending out surgeon communications for them to get involved

STS Adult Cardiac (c (continued)

STS Adult Cardiac (c (continued)

Unique Device Identifier

STS Adult Cardiac (c (continued)

• Version 2.9 new vendor screens, how’s it going
• Version 2.9 Data Submission:
• Has everyone submitted the new version 2.9 data to STS at least once? If not, you better not

wait and work out any issues now before last minute deadline

• DQR validation reporting anesthesia 3 pages of missing fields, even if you don’t participant in

the anesthesia submission

10 Minute Break

Be back in 10

Delaware Valley STS Group Update

Delaware Valley STS Adult Cardiac Regional Group Update Candace Trace

STS Adult Cardiac (C (Continued)

Isolated CABG Prolonged Vent Discussion

STS Adult Cardiac (C (Continued)

Isolated CABG Prolonged Vent Discussion

STS Adult Cardiac (C (Continued)

Isolated CABG Prolonged Vent Discussion

STS Adult Cardiac (C (Continued)

Isolated CABG Prolonged Vent Discussion If you are going to create a project to reduce the vent time you must:

• Agree to use STS or some other registry that can provide your hospitals baseline measurements as well as show any

improvements or unexpected outcomes

• You must get agreement to use the STS Start and End vent times as your only source of times
• Agree to only focus on a small identifiable group like Isolated CABG. This will insure the data outcome is not

muddied by some other influencing factor

• Anesthesia must be willing to work with any agreed changes to current process

What is your hospital doing or did do to reduce your vent time? Could someone or a group collect this information from our hospitals and send out a communications of what was sent? Is someone willing to take on this collection project? Should we reach out to Karen McNickle, STS presentation Can we come up with some conclusion of action steps and workflow processes for our hospitals to try.

15 Minute Break and Group Photo

Be in front hallway near sign-in desk in 5 minutes for group photo

Half Hour Lunch Break

Lunch provided in back of room

Watchman Procedure Presentation

Boston Scientific Joe Whitaker

Get With the Guidelines Overview

American Heart Association Alex Kuhn, Tawny Jackson, Chrystal Glodek

MACDM In Introduction and Updates

Mid-Atlantic Cardiovascular Data Managers, MACDM.org

When was it created and why? Fall of 2016. Since most of the hospitals cover more than just the cardiac registry that DVSTS covered, we wanted to expand the group to also discuss the thoracic and NCDR registries. It also became cost prohibited when the annual cardiac cost per hospital was increased to $2000 Do we have any rules we must follow? No one in the group is paid or compensated for any work No presenter is paid or compensated, other then free beverages/lunch No presenter can give political presentations What registries do we discuss? NCDR (National Cardiovascular Data Registry) – Cath/PCI, ACTION, ICD STS (The Society of Thoracic Surgeons) – Cardiac and Thoracic AHA (American Heart Association) – GWTG Any other registry the group would like to discuss

MACDM In Introduction (C (Continued)

How many onsite meetings per year do we have?

• Many hospitals no longer have the budgets to send staff to the STS and NCDR annual meetings. These

MACDM meetings will help communicate and discuss the important topics and presentations discussed during the STS and NCDR annual meeting.

• We hold two onsite meetings per year to discuss major STS, NCDR and AHA registry form changes, web

site updates, reporting and important presentations from the most resent spring/fall STS/NCDR annual meetings and any other sources.

• Spring meeting is a few weeks after the NCDR annual conference and focuses mainly on the NCDR

registries in the morning.

• Fall meeting is a few weeks after the STS annual conference and focuses mainly on the STS registries in

the morning. How must does it cost to attend the meetings?

• The cost is either an annual $100 per hospital fee or a $25 per attendee/per meeting fee
• If a hospital pays the annual $100 fee, they can send any number of staff to the meetings at no charge

MACDM In Introduction (C (Continued)

How was it created? Created under a current non-profit organization as an umbrella, we have no MACDM board or executives Allowed us to be created for $0 Filed official name (W-9 form), purchased annual MACDM.org web site address, purchased PO box, created bank account, files annual tax reporting Created new web site and paid annual internet site host charges Purchased MACDM table cover, lanyards and name tags Provide electronic screen display for our meetings and when we participate at conferences Process any vouchers, enrollment, registration, maintain web site helpdesk, pay all credit card transaction expenses

15 Minute Break

Be back in 15

NCDR ACT CTION

What is Changing NCDR (National Cardiovascular Data Registry) Beth Pruski

NCDR Cath/PCI

New Cath/PCI Form Version 5 NCDR (National Cardiovascular Data Registry) Connie Anderson

Cath/PCI – New Cath/PCI Version 5

The NCDR webinar of “Overview of the Cath/PCI Registry V5 Dataset” was very good and informative. Very difficult to get to on their website.

Cath/PCI – (c (continued)

From Procedure Inclusion: To Procedure Inclusion: Version 4 Version 5 To make our data collection process smoother, Can we still collect a Left Heart Catheterization only and still submit?

Cath/PCI – Continued

Optional Sections/Fields Our hospital system can decide which of the following optional sections/fields to be completed!

Section B. Episode of Care

• Admitting Provider’s Name, NPI - Fields
• Attending Provider’s Name, NPI – Fields
• Research Study – Only includes any NCDR research studies, not outside research studies

Section D. Pre-procedure information

• Seattle Angina Questionnaire (SAQ) - Section
• Rose Dyspnea Scale - Section

Section L. Discharge

• Discharge Provider’s Name, NPI - Fields

Section M. Follow-up (30 day and 1 year)(entire section M optional)

• Assessment Information
• Events
• Medications
• Seattle Angina Questionnaire (SAQ) Follow-up
• Rose Dyspnea Scale Follow-up

Cath/PCI – Further Discussion

Section C. Cardiac Arrest From one field to many fields

Cath/PCI – Further Discussion

Syntax score, very important in evaluating the AUC (appropriate use criteria). Obtaining this calculation is going to be very cumbersome.

Cath/PCI – Further Discussion

These fields are heavily dependent on physician documentation based on the detailed definitions in the data elements.

Cath/PCI – Further Discussion

Only need to complete if stenosis is >= 50% in native or graft vessels, reducing the burden of completing all vessels.

IC ICD – New or Future NCDR Announcements

Nothing to disclose at this time.

Future Events or Topics

Possible day bus trip to New York Wineries September 2018. Nancy Krempasky update Volunteers: We need someone to volunteer to take pictures:

• I will provide auto camera and training
• Have to be here 15 minutes before meeting starts
• Take a few pictures of the presenters
• Take a few pictures of everyone seated

We need someone to present one registry (either cardiac or cath/pci). I will help you with creating presentation and the presentation itself Any projects for any registries we would like to do as a twice a year web ex project? Example: Can we get together to ask STS and NCDR to change the DQR (Data Quality Report)? I think we can also partner with Ohio data managers and have a more powerful voice. Ex: Work with STS adult cardiac ask to remove anesthesia fields if not participating in anesthesia for DQR reports CME credit for our MACDM meetings - Contacted Ohio group to find out how they got the CME credits for their meetings but not practical Do we want a registry vender presentation (Lumedx, etc) EMR vender specific discussion (EPIC, etc) Any additional registry to discuss, specific fields discussion and process improvement All the spring and fall MACDM meeting to be on webex (voice, video, presentation? Had a number of inquires at Washington NDCR conference from Lousiana and California for them to participate. How did this format work? What future topics would you like to hear for spring meeting? Already have one manufacter lined up and another cool presentation in works Meeting Survey?

MACDM Closing

• Next NCDR Data Managers Conference March 7-9th 2018 – Caribe Royal Orlando, Orlando, FL
• Next MACDM meeting Tuesday, April 10, 2018 (main focus NCDR Cath/PCI and ICD registries) location to be determined
• Next STS Data Managers Conference September 26-28th 2018 – Loews Hollywood Hotel, Los Angeles, CA
• Thanks again Lehigh Valley Hospital for hosting this meeting!
• Watch MACDM.org for new meeting pictures and minutes to be announced!
• Please drop lanyard and name tag in container in rear of room when you leave