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ACEP Now: Vol 36 – No 06 – June 2017ILLUSTRATION: Chris Whissen & shutterstock.com
As part of its ongoing commitment to assist emergency physicians with providing the highest quality of emergency care, ACEP developed the Clinical Emergency Data Registry (CEDR). This is the first emergency medicine specialty-wide registry at a national level designed to measure and report health care quality and outcomes. It also provides data to identify practice patterns, trends, and outcomes in emergency care. CEDR is an evolving registry that will support emergency physicians’ efforts to improve quality and practice in all types of emergency departments even as practice and payment polices change over the coming years. CEDR has re-qualified as a qualified registry by the Centers for Medicare & Medicaid Services (CMS) for 2017 and is waiting for CMS to complete its annual required review of its 2017 Qualified Clinical Data Registry (QCDR) application.
Instead of physicians being mired in an alphabet soup of reporting requirements, CEDR allows for single data capture to fulfill the requirements of multiple programs, making physician quality reporting more efficient. The health care environment is transitioning from volume-based to value-based payment for care. The CEDR registry ensures that emergency physicians, rather than other parties (eg, payers), are identifying what practices work best for whom.
CEDR was developed under a sophisticated information technology infrastructure and has been phased in over the past few years in terms of the number of participating emergency departments, scope, and functionality. After a modest pilot project in 2015 with 13 emergency departments, CEDR grew in 2016 to more than 60 emergency departments with nearly 3 million patient records represented in the registry. The 2,500 physicians participating in CEDR last year had their quality data successfully reported to CMS, not only protecting their revenue but providing new insights into the quality of their patient care. Sites participating in CEDR for 2016 received a 1,400 percent return on investment, which is a major success for the program. For 2017, CEDR is anticipating exponential growth, with data for more than 15,000 providers and 20 million patient visits slated to be reported by CEDR to CMS.
In the background, members of ACEP’s CEDR committee, led by Stephen Epstein, MD, MPP, FACEP, have been building a large set of quality measures and methods to collect required data from emergency department patient care records. Dr. Epstein has been the ACEP leader of the development of this registry for seven years.
In addition to Dr. Epstein, more than 100 ACEP members have provided guidance to the construction of CEDR through CEDR subcommittees. The CEDR Committee is working hard to create a robust organizational structure to guide the future of this rapidly growing registry. The four subcommittees (research, measures, education, and outreach) have been active in making CEDR a valued partner in physician quality endeavors. Highlights of current subcommittee activities include:
- Developing a research infrastructure and protocols to allow researchers access to the de-identified CEDR database.
- Working with the ACEP Quality and Patient Safety Committee, continuing to refine the CEDR measure sets with emergency medicine–relevant reporting measures that can be used across all payers, one of the major advantages of a QCDR like CEDR in quality reporting to CMS.
- Implementing Maintenance of Certification (MOC) Part IV for our ABEM diplomates. That’s correct: ABEM diplomates will be able to complete their MOC Part IV requirements right from their CEDR dashboard. Beta testing is scheduled to begin for this feature soon, and it will be ready to roll out in late autumn this year.
The CEDR Committee is supported by the new Quality Division within ACEP, which is developing an array of analog and digital programs to assist ACEP members in their practice.
The CEDR team wishes to thank the dedicated support of ACEP members who guide CEDR in providing the highest value of reporting for all participants in this quality journey. For more information about CEDR, or if you are interested in participating in the registry, please email CEDR@acep.org.
Dr. Goyal is associate executive director for quality at ACEP.
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