PINNACLE Registry: Current Status and Future Direction

1. PINNACLE Registry: Current Status and Future Direction ACC Board of Governors William J. Oetgen, MD, MBA, FACC September 12, 2010

2. PINNACLE Registry • PINNACLE (Practice INNovation And CLinical Excellence) • Originally “IC3 Pilot” • NCDR Registry for ambulatory CV practice quality improvement • Initiated in 2008 • Currently ~829,000 patient encounter records • ~40 practices across the US submitting data • ~169 practice sites

3. PINNACLE Registry • June 2010 • PINNACLE Registry • Achieved sufficient mass of patient record input • Question arose: • Now that the concept has been demonstrated, how should PINNACLE develop in the future? • PINNACLE Presidential Strategic Planning Task Force • Develop a 3 – 5 year strategic plan • Identify resources needed to execute the plan • Report to BoT in December 2010

4. PINNACLE Strategic Planning Task Force • Appointed Members • Bill Oetgen, Chair • John Brush, Vice Chair • Mike Mirro (IT) • John Rumsfeld (NCDR) • Jere Hines (Clinical Practice Council) • Rick Nishimura (Education) • Blair Erb (PINNACLE Network) • Joe Drozda (Quality)

5. PINNACLE Strategic Planning Task Force • Charge of Task Force • Develop 3 – 5 Year Strategic Plan • Identification of Resources • Report to the Board of Trustees in December 2010

6. PINNACLE Strategic Planning Task Force • Charge of Task Force • Develop 3 – 5 Year Strategic Plan • Identification of Resources • Report to the Board of Trustees in December 2010 • Process: • Broad member-based input via listening sessions for SWOT analyses • Transparency and no preconceived outcome • Consensus or majority and minority reports

7. PINNACLE Strategic Planning Task Force • Listening Sessions to date • 7 key member groups • NCDR – MB • PINNACLE Network • Clinical Quality Committee • Clinical Practice Council • HIT Committee • Education Committee • Cardiovascular Team Council

8. PINNACLE Strategic Planning Task Force • Listening Sessions to be completed • 2 key groups • Practice Administrator Advisory Work Group • ACC Senior Staff

9. PINNACLE Strategic Planning Task Force • Snapshot of Initial Findings • PINNACLE Strengths • Innovative • Operational for more than two years • ACC member-driven • Responsive to IOM’s Six Domains of Quality • Safe, effective, timely, patient-centered, efficient, equitable

10. PINNACLE Strategic Planning Task Force • Snapshot of Initial Findings • PINNACLE Weaknesses • Lack of complete buy-in within ACC – system development is not our core competency • No long range strategic partner – industry, payer, EHR company • Single specialty - not appealing to large health care systems

11. PINNACLE Strategic Planning Task Force • Snapshot of Initial Findings • PINNACLE Opportunities • Potential to change the way CV medicine is practiced with focus on quality and value, not volume • Potential strong alignments with other specialties • Education – life-long learning and MOC • Medical professional liability risk reduction

12. PINNACLE Strategic Planning Task Force • Snapshot of Initial Findings • PINNACLE Threats • No clear monetary ROI and lack of reliable funding stream • Currently registries do not meet MU criterion for data reporting to CMS • User frustration, impatience, and questions of data quality • Expecting PINNACLE to do things it was not designed to do – e.g. salary bonus determinations

13. PINNACLE Strategic Planning Task Force • Task Force Logo

14. PINNACLE Strategic Planning Task Force • Task Force Logo PINNACLE

15. Member Sections & Communities What they are… Fellow in Training Early Career Fellow / FACC Emeritus CCA Practice Admin. Sections: Adult Congenital & Pediatric Cardiology, Cardiovascular Team, Women in Cardiology, Interventional Scientific • Communities • A group of members defined by a general population characteristic. • Current segments include: FIT & Early Career, CCA, Emeritus, practice Administrators • Section • A group of members who actively align themselves around an area of clinical or professional interest • Sections are governed by their respective governing Council Committees & Councils BOG & Trustees • Council • Governing body of the Sections. Work with Committees, BOG, & BOT to introduce initiatives and advocate on the behalf of member sections. • Members appointed by the President or ex-officio. Executive Committee Pres. Team

16. Current ACC Sections • Adult Congenital and Pediatric Cardiology • Cardiovascular Team • Interventional Scientific • Women in Cardiology Current ACC Councils • Council on Cardiovascular Care of Older Adults • Clinical Practice • Imaging Council • Surgeons Council

17. Sections Working for ACC • Member involvement and leadership opportunity increases, increasing member loyalty • Opportunities for ACC to identify emerging leaders • Section leaders articulate the needs of clinical or professional interest to ACC leadership • Small dues for Section membership supports initiatives relevant to the professional needs

18. Committees : 65 standing committees, over 200 committees, councils, task forces, working groups, representatives, etc. comprised of ACC members (+ outsiders) appointed by the President identify/respond to strategic priorities within Education, Quality, Advocacy, Membership, Governance, etc. empowered to make recommendations, carry out work or special projects, to research, to work with staff to implement programs, to develop strategies to meet the mission of the committee and the College Committees are resources Committees

20. Governor Members on Committees • Governor committee members will report to the BOG and the BOG Steering Committee.  • BOG representatives on committees keep lines of communication open between the committee and the BOG. • Provide reports to the BOG and BOG Steering Committee on committee activities • Help identify opportunities for BOG involvement • Participate fully in the committees activities • Participate in BOG Steering Committee calls when appropriate