Download What is The Guideline Advantage?

Preventive Health
Partnership
Our organizations came together in 2004 to:
–
Harness the individual strengths of each to collectively engage the issue
of prevention
–
Create consistent prevention and screening guidelines
–
Reach widest constituency to increase awareness and inspire action
–
Further collective goals through joint initiatives
Prevalence of
Chronic Diseases
•
81 million American adults have one or more types of cardiovascular
disease1
•
As many as 1 in 3 American adults will have diagnosed diabetes in 2050 if
present trends continue2
•
Approximately 1/3 of cancer deaths are related to overweight or obesity,
physical inactivity and poor nutrition, and nearly 1/3 are caused by tobacco use;
more than 2/3 of cancer deaths are potentially preventable3
•
Improved screening and counseling can result in prevention, treatment and
early detection
1 Heart Disease and Stroke Statistics 2010
2 http://www.pophealthmetrics.com/content/8/1/29
3 ACS Cancer Facts and Figures 2010
Framework for
Collaboration
Focus on four things that can help prevent cancer, diabetes, heart
disease and stroke:
•
Be physically active
•
Eat well (maintain a healthy weight)
•
Don’t smoke
•
See your health care provider regularly
The Tri-Agency Relationship
What is The Guideline Advantage?
Program Advantages
– A joint program of the American Cancer
Society, the American Diabetes
Association, and the American Heart
Association
– Each organization has long developed
scientific statements and guidelines
specific to prevention and disease
management
– Shared goals:
– Sets national goals and objectives
that compliment their guidelines
– Common interest in translating those
guidelines into practice
Multiple
participation
models
Expanded
feedback
for quality
improvement
Reaching a
broad range
of patients
Research and
Recognition
opportunities
Online
improvement
tools
Working with
existing
technology
Vision & Goal
Vision
Goal
To improve the health of all patients through widespread
application of primary and secondary prevention guidelines in
the United States through data collection, analysis, feedback
and quality improvement in the ambulatory setting.
To improve the long-term compliance with the ACS, ADA and
AHA/ACC guidelines, which in turn supports our shared
organizational mission to prevent chronic diseases and to
improve the lives of those living with the nation’s most
prevalent chronic diseases.
The Guideline Advantage is based on the success of nearly 10 years experience in inpatient
quality improvement and over 2 millions lives touched.
Program Model
2• Technology vendors
submit collective clinical
data to DCRI for
The Guideline Advantage
3• Data are processed,
analyzed and sent back
to the providers or
medical practices
1• Providers can use
several different
technology platforms
4• Performance is measured,
Professionals can set
measureable goals and chart
improvements in performance
What are the different participation models?
There are three main approaches to populating the registry with clinical data:
Description
Direct Vendor
Model
Practice
Managed
Model
Zero
Configuration
Model
• The electronic health records (EHR) vendor
enables the data to flow by mapping to the
data warehouse on behalf of its customers
(the practices);
• Medical practices that have technical staff
on site can map to the warehouse directly;
• Medical practices that do not have technical
staff on site can submit a “flat file” of data,
and DCRI will map those data into the
warehouse for the practice.
Additional information at: www.guidelineadvantage.org
Important Things to Understand
1. Data quality and performance
reports are then generated on
a quarterly basis to help
practices identify where they
may have areas for
improvement.
2. The Guideline Advantage offers
an array of CE/CME
opportunities, better practices,
tools and resources for health
care professionals to consider
incorporating into their
practices to improve.
Technically speaking… how does it work?
As a part of quality improvement, clinical data must be aggregated into a data warehouse
to facilitate analysis and reporting.
DATA WAREHOUSE AND
REPORTING
ELECTRONIC
MEDICAL RECORD
Data Staging Area
Data import
Key activities include:
- Cleaning data
- Reconciling data
- Standardizing data
- Transforming data
De-identification &
Data Extract
(data submission
process)
Report
Data
Database
Feedback Reports
Research &
Analytics
The Guideline Advantage’s Ideal Data Elements (2011)
Demographics
Risk Factor
Mortality
Contraindications
Medical
History
Ideal Data
Elements
Medications
Hospitalizations
Vital Signs
Labs
*full list of elements can be found at
http://guidelineadvantage.org
Mock Report
New Data Elements
New Measures
•Cervical cancer screening
•Breast cancer screening
•Colon cancer screening
•Pneumococcal Vaccine
•Influenza Vaccine
•Sodium
•Dental exam in previous 12 months
•Currently Pregnant
•Mortality
•Cancer Prevention Measures:
Cervical Cancer Screening
Breast Cancer Screening
Colon Cancer Screening
•ABCS (Aspirin, Blood Pressure, Cholesterol,
Smoking), including those measures used in
initiatives like Million Hearts.
A: Aspirin or other antithrombotic in IVD
B: Screening for high blood pressure
B: Controlling High Blood Pressure
C: Cholesterol: Fasting LDL and riskstratified LDL
C: Complete lipid panel and LDL control in
IVD
S: Smoking: Tobacco use screening and
cessation intervention
• Pneumococcal vaccine
• Influenza Vaccine
The Guideline Advantage Alignment with PQRS
The difference in The Guideline Advantage metrics and those reported by PQRS is the code sets
used to calculate them. To date the program has faced challenges in receiving all of the codes
sets required to calculate PQRS measures (specifically, CPT codes).
Efforts to further align with PQRS measures
-
Continue to ask for CPT codes from all participants (just received our first ones!)
-
Exploring creation of a limited report focusing on the cardiac prevention measures for QIO’s
What specialties are eligible to participate?
•
Cardiology
• OB/GYNs
•
Family Medicine
• Osteopathic Medicine
•
Geriatric Medicine
• Oncology
•
Internal Medicine
• Endocrinology
•
Neurology
Patient Inclusion Criteria
ALL Patients 18 and Over
How does a provider register?
Key Takeaways
Additional information at GuidelineAdvantage.org
•
Register on our website at
guidelineadvantage.org to
express your interest.
•
Upon registration, a member of
our team will contact you and
begin work to identify which
data transfer model may be
best for your practice.
Site Implementation Timeline
DCRI
Shares Contracts (Participation
Agreement and Business
Associate Agreement) and
Technical Specifications and
Implementation Packet with Site
(3-5 days following registration)
Site
Registers
online
Site
Gather
Glossary/Fields
(1 day)
Site
Map Coded
Fields
(3 days)
DCRI
DCRI
Verify/Validate Data
Test Data Sample Transfer
(5 days)
(3 days)
Site
Site
Transfer Data Completes
Sample
Contracts
(2 days)
Site
Submit Historical Data
(3 days)
HIPAA
HIPAA applies to The Guideline Advantage since Protected Health Information (PHI) is used in
the program. The Guideline Advantage is considered Quality Improvement as opposed to a
clinical trial/research, so the disclosure of PHI to DCRI, including direct patient identifiers, falls
under healthcare operations.
Leading practices for effective participation
Use existing EHR platform; don’t interrupt work flow to collect data; offer multiple ways for
data to flow (from EHR vendor, from intermediary vendor, directly from practice, etc.)
Provide tools and resources (Webinars, CME programs, etc.) to help develop a culture of
quality improvement
Provide feedback reports and consult with practices on how to share information
Encourage focus on 1-2 areas only
Direct practices to resources to support improvement
Recognize and link to incentives
These are just a few of the best practices shared by the program.