1. ACTION Registry

2. Objectives of the NCDR Registries Provide data standardization Provide data that is –Relevant, Credible, Timely, Actionable Present real life outcomes that help providers improve care Help Participants meet consumer, payer, and regulator demands for quality care

3. Background In 2004, the prevalence of CAD was 15.8 million in the U.S., causing one in five deaths1 In 1997, there were over five million visits to U.S. emergency departments for the evaluation of chest pain and related symptoms.3 There is strong evidence that the best treatments and strategies for these patients are not always utilized.

4. Background Cont. Recent registries have documented patterns of care for ACS, and have demonstrated that guidelines adherence is sub-optimal for a large proportion of ACS patients. Despite targeted quality improvement efforts within these registries, treatment patterns for many high-risk sub- groups of patients remain sub-optimal and treatment disparities persist. The ACTION Registry™ has thus been created to provide among the largest, most comprehensive national ACS database and quality improvement initiative ever developed, enabling hospitals to measure their performance in treating patients with ACS against national benchmarks.

5. Purpose of the ACTION Registry A national surveillance system –Assess characteristics, treatments, and outcomes of patients hospitalized with ACS –Focusing on high risk patients with STEMI and NSTEMI Optimize outcomes and management of ACS patients –Implement evidence-based guideline recommendations in clinical practice Facilitate efforts to improve quality & safety of ACS care Investigate novel quality improvement methods

6. ACTION Registry™ Audience: Cardiologists, emergency medicine physicians, hospitalists, primary care physicians, nurses, physician assistants, nurse practitioners, pharmacists, case managers, allied health care personnel, hospital quality improvement personnel and administrators, professional organizations, accrediting organizations, regulatory agencies, payers, pharmaceutical and device industry, and clinical research organizations

7. Registry No charge for participation Funding provided by –Genentech –Bristol-Myers Squibb and Sanofi Partnership –Schering Plough Corporation CRUSADE and NRMI sites enrolling V1 launched V2 being developed with CathPCI v4 for linkage Data Sharing Early discussions with payers Research Will be initiated in 2007 Q3 38 60 93 101

8. About the ACTION Registry National registry Represents two prior ACS registries –NRMI (National Registry of Myocardial Infarction) and –CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC and AHA Guidelines) Access to NCDR™ support services such as: –Clinical/Technical Support –Quarterly Reports –Training and Orientation No Charge for Participation due to funding provided by –Genentech –Bristol-Myers Squibb Corporation/Sanofi Partnership –Schering Plough Corporation

9. Registries Work QI demonstrated in NRMI and CRUSADE outcome studies. Registries provide: –reports to monitor use and outcomes of evidence- based medicine. –benchmarking information based on standardized definitions. –adapt and explore new metrics in a confidential environment. –help clinicians to help hospitals assess quality of care.

11. CRUSADE

12. Future ACTION v.2.0 Data vendor submission option ORYX and CMS data submission

13. ACTION v.2.0 Will: Include performance measures and quality indicators from ACC/AHA, JCAHO/CMS, CRUSADE, NRMI Include quality metrics and corresponding data elements for participant process improvement. Incorporate the comparison of elements and definitions from ACC/AHA Data Standards, STS, CathPCI 4.0 and other NCDR TM registries Incorporate elements from D2B Alliance (Time-to- Reperfusion) workgroup

14. Data vendor submission option ACTION v.2.0 will include software vendors for data submission Specifications will be released and certification of vendors will take place early 2008

15. ORYX and CMS data submission data elements are aligned with the like JCAHO and CMS measures ACTION v.2.0 will incorporate data elements in order to be aligned with CMS/JCAHO

16. ACTION Tool Development Take ACTION IC3-CAD QI Tools NCDR Web Based Education

17. How to Join Download the enrollment file from www. ncdr.com Complete your enrollment packet and submit the materials to the NCDR Receive Welcome Kit Complete online tool tutorial

18. For Additional Information NCDR Website:www.ncdr.com Service Center:(800) 257-4737 Monday –Friday, 8:00 am – 5:00 pm ET E-mail:ncdr@acc.org Fax:(202) 375-6843 Mailing address:2400 N Street NW Washington, DC 20037