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PASSION for Peripheral and Endovascular Current Status of the Vascular Quality Initiative

PASSION for Peripheral and Endovascular Current Status of the Vascular Quality Initiative. Jack L. Cronenwett, M.D. Medical Director Society for Vascular Surgery Patient Safety Organization. Current Status. 300 Centers, 45 states, 2500 Physicians

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PASSION for Peripheral and Endovascular Current Status of the Vascular Quality Initiative

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  1. PASSION for Peripheral and EndovascularCurrent Status of the Vascular Quality Initiative Jack L. Cronenwett, M.D. Medical Director Society for Vascular Surgery Patient Safety Organization

  2. Current Status • 300 Centers, 45 states, 2500 Physicians • 50% vascular surgeons, 30% cardiologists/radiologists • 12 Registries within a Patient Safety Organization • Carotid, aortic, peripheral, dialysis, IVC filter, venous • 170,000 procedures, one-year follow-up MD office • Matched with SSDI and Medicare claims late follow-up • Focused on QI in 16 regional quality groups • Two current post-approval surveillance studies • One randomized clinical trial

  3. Successes • Rapid growth, web-based system, real world data • 31% academic, 30% affiliated, 39% community centers • Annual validation of consecutive cases entered • By comparison with claims data from each center • Detailed clinical data, with 1 yr follow-up in 70% • Late outcomes by Medicare claims data matching • Feedback specific data to sites  changed practice • Real time reporting, anonymous comparison to others

  4. Challenges • Cost is a barrier for some centers to participate • VQI support, but also substantial cost of data entry • One-year follow-up missing in 30% cases • Despite best efforts; need to supplement with claims • Volunteer work by society members limited • Growth requires more investment in infrastructure • Obtaining claims data for “quality improvement” • CMS data usage agreements specify “research”

  5. Future Priorities • Data elements incorporated in EHR systems • Avoid duplicate data entry; use data during care process • Mechanism for rapid access to Medicare claims • Important for unbiased tracking of late outcomes • Patient reported outcome measures • Quality of life, late results, especially in young patients • Capture charge/cost data from sites • Allow value-based calculations and comparisons

  6. Future Priorities • Harmonize core data set with other registries • International vascular registries, NCDR PVI registry • Increase use by industry for PAS and PMA • Efficient use of existing data for all stakeholders • Increase international collaboration • Both device evaluation and research projects • Develop new registries for medical management • Disease-based rather than procedure-based focus

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