2. Project Goals Enhance culture within cardiology practice that data is important. – Decreased variation in the practice. Fix a problem at a local level and enhance the whole Epic community by sharing it with everybody else. Increase Participation in the PINNACLE Registry. Apply knowledge to other specialties.

3. The Project: Quick Recap Spring PAC session 13: Structured Cardiology Note with Registry Reporting

4. NoteWriter Discrete Data Elements for Reporting Capture Data within Workflow Reduce Note Writing Time Data Collection & Submission

5. Clarity ________ NoteWriter notes and other clinical workflows Crystal Report exported to XML Administrative utility Data to ACC & confirmation

6. About the PINNACLE Registry With millions of patient records, the PINNACLE Registry® is the world’s largest cardiovascular outpatient quality improvement registry. A component of the ACC NCDR® suite of clinical registries, the PINNACLE Registry gives cardiologists the credible quality measurement solutions needed to survive in today’s demanding health care environment. The registry provides a centralized system for clinical practices to promote practice innovations and achieve clinical excellence.

7. The PINNACLE Outpatient Registry tracks patients beyond the hospital… Patient Conditions Coronary Artery Disease Heart Failure Atrial Fibrillation Hypertension Goals Measure adherence to clinical guidelines Eliminate and reduce variations in care Improve care coordination for CV patients Facilitate overall improvement in outpatient care Source & Credits: ACC

8. 14M+ million encounters covering 3.4M unique patients Source & Credits: ACC

9. Project Challenges Follow Evolving Guidelines Promote Adoption Compare Yourself to Others Improve/Standardize Processes

10. Project Challenges Follow Evolving Guidelines Promote Adoption Compare Yourself to Others Improve/Standardize Processes

11. Follow Evolving Guidelines CHA2DS2-VASc Score JNC 8 Guidelines for High Blood Pressure Management CV Diagnostic Testing Appropriate Use Criteria SYNTAX HAS-BLED Bleeding Risk 2013 ACC / AHA CV Prevention Guidelines Risk Calculators (Lipid, STS, etc.)

12. Project Challenges Follow Evolving Guidelines Promote Adoption Compare Yourself to Others Improve/Standardize Processes

13. Compare Yourself to Others PINNACLE CAD AFib Hypertension Heart Failure Clarity KPIs Reporting Workbench Universe

14. Project Challenges Follow Evolving Guidelines Promote Adoption Compare Yourself to Others Improve/Standardize Processes

15. Promote Adoption 1 1 Guideline-based care Standardize Processes Comparison to peers 2 2 PINNACLE is a qualified registry for MU stage 2 reporting. 3 3 Swedish Medical Center Experience

16. ACC Goals Improve care in chronic cardiovascular disease (CAD, HTN, afib/flutter, HL, etc.) Increase efficiency and effectiveness of clinical encounter documentation Facilitate participation in the PINNACLE Registry (  MU Stage 2 menu objective)

17. Agenda Project Goals & Challenges Demo The Process: Collaboration with Epic Lessons Learned & Vision The Future

22. Text Generation

26. CHADS2 Calculator

36. Demo: Data Submission to ACC Run Clarity Extract Run XML Submission Utility Receive InBasket Confirmation

37. Licensing & Resources Licensed for EpicCare-Ambulatory Licensed for ACC-NCDR Registry Communication Module Participant agreement with the NCDR

38. Licensing & Resources Review content ◦ Consult with Cardiologists ◦ Don’t remove elements with hearts ◦ Work with compliance on color-coding

39. Collaboration Buy in: Society and professional members have agreed the project has national importance. Guidance: Voice of ACC helped filter out conflicting development direction suggestions. Commitment: ACC leadership works closely with Cupid R&D and acts as liaison for other members.