The document discusses challenges in data management for accurate reporting in cardiology, emphasizing the importance of quality documentation to maximize reimbursement and ensure patient satisfaction. It highlights various case studies from different healthcare settings that face issues such as missing or inaccurate data and the need for better integration of technology. Proposed solutions include engaging leadership, process and technology changes, and improving coordination among healthcare providers.

1. ACC Reporting: Overcoming Data Management
Challenges
Dr. Saji Salam MD, MBA
Director of Clinical Informatics
David LaMotte BCS
Senior Product Manager, PVMD Cardiology

2. Forces of Change
■ Practice Integration
■ Reimbursement Scrutiny
■ 24% of denials related to MS-DRG 247
■ Top reason: Documentation did not substantiate
the need for admission
■ Appropriate Use Criteria
Bottom Line:
Quality documentation and reporting is becoming critical

3. 0%
10%
20%
30%
40%
50%
60%
70%
90%
100%
80%
N=205
79%
Maximize reimbursement:
47%
75%
Improve patient satisfaction:
42%
67%
Admin
Reduce costs in the cath lab:
41%
Cath Lab Goals
65%
Report quality measures:
48%
Physician
62%
Achieve meaningful use:
31%
59%
Prepare/prevent RAC audits:
31%
Improve care coordination/ 57%
communication with hospital: 29%
Improve care coordination/ 56%
communication with referring
physicians: 27%
Monitoring and improving 53%
appropriate use measures: 40%
Improve integration of 52%
technology within cath lab: 32%

4. Cath Lab Goals
Administration
Goal Cardiologist Ranking
Ranking
Maximize reimbursement: 1 2
Improve patient satisfaction: 2 3
Reduce costs in the cath lab: 3 4
Report quality measures: 4 1
N=205

5. Drivers for data management
■ Quality is priority
■ Reimbursement
■ AUC criteria
■ Audits
■ Meaningful use
■ Patient satisfaction
■ Others…

6. Current State
Procedure
Office Report
Note
EMR
Hemo NCDR
Billing

7. Case Studies
Case 1: Stand-alone, for-profit hospital in the North East
• Using procedure documentation system for nearly all procedures
• One full-time (PhD) and two part-time dedicated to reporting
Case 2: Health System in the Upper Midwest
• Using procedure documentation for majority of cases
• Two full-time and one part-time nurse dedicated to reporting
Case 3: Large health system in a major city
• No procedure documentation system; use dictation
• Uses two different systems for Echo and Nuke
• 3 full-time nurses dedicated to reporting

8. Summary of Issues
■ Missing data
■ Incomplete / inaccurate data
■ Inconsistent data
■ Redundant data entry
Result: Large effort, sometimes 3 hours per case .
Result: Backlog of quality projects.

9. Challenges
■ Technical
• Number of Data Sources
• Integration
• Source of Truth?
• IT Capacity
■ Human
• Conflicting Perspectives
• Process Inertia
• Attitudes Matter
■ Financial

10. Proposed point of arrival architecture

11. Case Study: Current State

12. Case Study: Interim State

13. Road map
• Current Process
• Costs / Opportunities
• Prioritize
• Engage leadership and stakeholders
• Sell to key stakeholders and
policymakers
• Process changes
• Technology changes
• Integration changes