Preventive Health Partnership

2. Preventive Health Partnership Our organizations came together in 2004 to: Harness the individual strengths of each to collectively engage the issue of prevention Create consistent prevention and screening guidelines Reach widest constituency to increase awareness and inspire action Further collective goals through joint initiatives

3. Prevalence of Chronic Diseases 81 million American adults have one or more types of cardiovascular disease1 As many as 1 in 3 American adults will have diagnosed diabetes in 2050 if present trends continue2 Approximately 1/3 of cancer deaths are related to overweight or obesity, physical inactivity and poor nutrition, and nearly 1/3 are caused by tobacco use; more than 2/3 of cancer deaths are potentially preventable3 Improved screening and counseling can result in prevention, treatment and early detection 1 Heart Disease and Stroke Statistics 2010 2 http://www.pophealthmetrics.com/content/8/1/29 3 ACS Cancer Facts and Figures 2010

4. Framework for Collaboration Focus on four things that can help prevent cancer, diabetes, heart disease and stroke: Be physically active Eat well (maintain a healthy weight) Don’t smoke See your health care provider regularly

5. Multiple participation models Expanded feedback for quality improvement Online improvement tools Reaching a broad range of patients Working with existing technology Research and Recognition opportunities The Tri-Agency Relationship Program Advantages • A joint program of the American Cancer Society, the American Diabetes Association, and the American Heart Association • Each organization has long developed scientific statements and guidelines specific to prevention and disease management • Shared goals: • Sets national goals and objectives that compliment their guidelines • Common interest in translating those guidelines into practice What is The Guideline Advantage?

6. Vision & Goal • To improve the health of all patients through widespread application of primary and secondary prevention guidelines in the United States through data collection, analysis, feedback and quality improvement in the ambulatory setting. Vision To improve the long-term compliance with the ACS, ADA and AHA/ACC guidelines, which in turn supports our shared organizational mission to prevent chronic diseases and to improve the lives of those living with the nation’s most prevalent chronic diseases. Goal The Guideline Advantage is based on the success of nearly 10 years experience in inpatient quality improvement and over 2 millions lives touched.

7. Program Model • Technology vendors submit collective clinical data to DCRI for The Guideline Advantage 1 2 3 4 • Data are processed, analyzed and sent back to the providers or medical practices • Providers can use several different technology platforms • Performance is measured, Professionals can set measureable goals and chart improvements in performance

8. What are the different participation models? There are three main approaches to populating the registry with clinical data: Important Things to Understand Description Practice Managed Model Direct Vendor Model Data quality and performance reports are then generated on a quarterly basis to help practices identify where they may have areas for improvement. The Guideline Advantage offers an array of CE/CME opportunities, better practices, tools and resources for health care professionals to consider incorporating into their practices to improve. Zero Configuration Model • The electronic health records (EHR) vendor enables the data to flow by mapping to the data warehouse on behalf of its customers (the practices); • Medical practices that have technical staff on site can map to the warehouse directly; • Medical practices that do not have technical staff on site can submit a “flat file” of data, and DCRI will map those data into the warehouse for the practice. Additional information at: www.guidelineadvantage.org

9. Technically speaking… how does it work? As a part of quality improvement, clinical data must be aggregated into a data warehouse to facilitate analysis and reporting. Data Staging Area DATA WAREHOUSE AND REPORTING • Key activities include: • Cleaning data • Reconciling data • Standardizing data • Transforming data ELECTRONIC MEDICAL RECORD Data import De-identification & Data Extract (data submission process) Database Report Data Feedback Reports Research & Analytics

10. The Guideline Advantage’s Ideal Data Elements (2011) *full list of elements can be found at http://guidelineadvantage.org

11. Mock Report

12. The Guideline Advantage Alignment with PQRS The difference in The Guideline Advantage metrics and those reported by PQRS is the code sets used to calculate them. To date the program has faced challenges in receiving all of the codes sets required to calculate PQRS measures (specifically, CPT codes). Efforts to further align with PQRS measures Continue to ask for CPT codes from all participants (just received our first ones!) Exploring creation of a limited report focusing on the cardiac prevention measures for QIO’s

13. What specialties are eligible to participate? Cardiology Family Medicine Geriatric Medicine Internal Medicine Neurology Patient Inclusion Criteria ALL Patients 18 and Over OB/GYNs Osteopathic Medicine Oncology Endocrinology

14. How does a provider register? Key Takeaways • Register on our website at guidelineadvantage.org to express your interest. • Upon registration, a member of our team will contact you and begin work to identify which data transfer model may be best for your practice. Additional information at GuidelineAdvantage.org

15. Site Implementation Timeline DCRIShares Contracts (Participation Agreement and Business Associate Agreement) and Technical Specifications and Implementation Packet with Site (3-5 days following registration) DCRIVerify/Validate Data Transfer (3 days) DCRITest Data Sample (5 days) SiteGather Glossary/Fields(1 day) SiteMap Coded Fields(3 days) SiteTransfer Data Sample(2 days) SiteCompletes Contracts SiteRegisters online SiteSubmit Historical Data(3 days)

16. HIPAA HIPAA applies to The Guideline Advantage since Protected Health Information (PHI) is used in the program. The Guideline Advantage is considered Quality Improvement as opposed to a clinical trial/research, so the disclosure of PHI to DCRI, including direct patient identifiers, falls under healthcare operations.

17. Leading practices for effective participation Use existing EHR platform; don’t interrupt work flow to collect data; offer multiple ways for data to flow (from EHR vendor, from intermediary vendor, directly from practice, etc.) Provide tools and resources (Webinars, CME programs, etc.) to help develop a culture of quality improvement • Provide feedback reports and consult with practices on how to share information • Encourage focus on 1-2 areas only • Direct practices to resources to support improvement • Recognize and link to incentives These are just a few of the best practices shared by the program.