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Transitions in Care-Heart Failure
ACC Quality 2009 D2B-Sustain the Gain Transitions in Care-Heart Failure Patient Centered Care Transformation The IC3 Program
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Goal Improving Continuous Cardiac Care
Help clinicians thrive in a performance-based reimbursement system through the systematic practice, timely reporting, and continuous improvement of quality Goal Improving Continuous Cardiac Care
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Outpatient Performance Measures
CAD, Afib, HTN, Heart failure, Diabetes, Rehab ACC/AHA PCPI PQRI NQF There is not much emphasis
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Quality improvement Practice workflow redesign
Transactional quality and management Incentives
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Office-based quality improvement program that enables participants to select, based on practice characteristics, the most appropriate level of engagement What is it?
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The IC3 Program Community Education Data Incentives Research
Performance Improvement Data Incentives Research
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Interactive communication.
Community Building The IC3 national network of practices dedicated to high quality CV care. Interactive communication. Best practices. There is not much emphasis
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Education Educational programming. Clinical guideline updates.
Selection of EHR vendors. Billing and coding. There is not much emphasis
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Data Collection Office-based registry.
Collect and use patient care data more effectively. Coordinate care. Benchmarking. Demonstrate quality of care.
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Performance Improvement
Practice assessment. QI tools. Decision support (CardioPATH). CardioPATH used IC3 data dictionary
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Recognition and Rewards
Incentives. Recognition. ABIM MOC. Payers. Malpractice. tipping points
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Research New insights on care delivery. Impact of program.
Practice-Based Research Network.
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Current ACC/AHA Performance Measures
CAD Performance Measures BP Measurement Symptom & Activity Assessment Smoking Assessment Anti-platelet Therapy Lipid Profile Use of Lipid Therapy -blocker post-MI ACE/ARB in EF & DM Screening for Diabetes CHF Performance Measures LVEF Assessment Weight Measurements BP Measurements Clinical Symptom Assessment Activity Assessment Signs of Volume Overload Patient Education -blocker in EF ACE/ARB in EF Warfarin for Afib Initial Lab Tests
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Current ACC/AHA Performance Measures
Afib Performance Measures Thromboembolic Risk Prior CVA/TIA Age ≥75 Hypertension Diabetes Heart failure or EF Warfarin use in High-risk pts Monthly INR in pts on warfarin Cardiac Rehabilitation PMs Referral to a Rehab Program Within 12 months of ACS PCI CABG Valve Surgery Transplant Stable Angina Diabetes Performance Measures Poor HbA1c (>9%) LDL Control (<100) BP Control (<140/80)
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Quality Vision, near and far
2009: prepare practices to succeed 2010: make quality business case 2011: link learning, performance, $ 2012: Quality First Network
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