Abstract P139: Implementation of the PINNACLE Registry™: Initial Experience and Insights from a Large Cardiovascular Practice in Texas

Abstract

BACKGROUND The PINNACLE Registry, the first national CV practice-based outpatient QI program, is designed to optimize the quality of care through the standardized collection and reporting of clinical data. However, implementation presents unique challenges. Multiple EHR systems, lack of standardized database structure and absence of unique field identifiers across EHR platforms make single solution electronic data extraction impossible. At the same time, paper data collection and submission is unwieldy. METHODS Cardiovascular Specialists PA (CVS) is a 7 physician single specialty cardiovascular medicine practice with three office locations in suburban Dallas. Approximately 20% of encounters are new patients. Staffing levels include 2 medical assistants, 2 receptionists, 2 full-time IT specialists and a 7 member in-house transcription pool. In order to facilitate practice-wide adoption, a 3-phased process was implemented beginning in February, 2009: Planning Phase (60 days): Evaluation of the existing patient care delivery system and development of tools needed to assist data collection Development Phase (75 days): A team at a single office location designated to “operationalize” the system and begin a 1 month trial data collection Implementation Phase: All physicians and offices were brought online using teaching materials and training sessions. Simultaneous teaching of non-physician staff included scripting and role playing techniques. CONCLUSION It is possible to implement a QI-based clinical registry in a busy outpatient practice with real time data acquisition and no disruption to patient flow. Success depends on involvement of the full cardiac care team in development and implementation of the program. Implementation among remaining practice members is easily accomplished using practical, hands-on training and internally developed materials and protocols. Decisions to adapt the data collection and submission process can be both medically appropriate and fiscally responsible.