To tell a story, all you need is information. To tell an accurate story, when it comes to patient care in the emergency department (ED), you need much more, according to ED data experts and emergency physicians James Augustine, MD, FACEP, and Stephen Epstein, MD, MPP, FACEP. An accurate story requires information from millions of ED visits, a way to analyze the data, and a way to use that analysis across different settings and patient populations for better outcomes. That’s where ACEP’s Emergency Medicine Data Institute (EMDI) comes into play.

Developed by ACEP, the EMDI is powered by member data from ACEP’s own clinical registry, the Clinical Emergency Data Registry (CEDR), and in collaboration with EQUAL, the College’s virtual quality network.

Emergency physicians who participate in ACEP’s clinical registries help all emergency physicians make swift, smart decisions.

“EMDI is the part of our practice that allows us to plan for the future of emergency medicine,” said Dr. Augustine, EMDI’s Board of Governors’ Vice Chair and clinical professor in the department of emergency medicine at Wright State University in Dayton, Ohio. “[Our practice] has changed and evolved, and will continue to do so. The only way to tell that story is with data that show those changes. It all leads to improvements in the way we provide patient care, adapt to the changing practice of emergency care, and how we serve our communities and the house of medicine.”

Data Repository

CEDR serves as the data repository that enables emergency physicians to effectively report quality metrics.

Established at a time when federal mandates tied physician reimbursement to quality measure reporting, CEDR met a critical need. Its aim was not just to fulfill regulatory requirements, but to ensure emergency physicians could define and control the measures that shaped their clinical practice. ACEP developed quality measures before CEDR was created nearly 10 years ago. But to avoid what Dr. Augustine called the federal government’s tendency to inflict measures on emergency physicians—he uses the word “inflict” purposely—CEDR provided a focused platform to help emergency physicians take charge of data reporting. In doing so, they avoid the pitfalls of externally imposed metrics that fail to reflect the intricacies of the specialty.

“The government is going to withhold a percentage of your reimbursement if you don’t report quality measures depending on your setting,” said Dr. Epstein, the EMDI’s Board of Governors’ Chair, attending emergency physician at Beth Israel Deaconess Medical Center, Boston, and assistant professor at Harvard Medical School. “Conversely, you can get a small bonus if you do well in your reporting. CEDR was created in part because the College recognized that a lot of our members would not have the infrastructure to do that reporting. Now, we realize that there’s an awful lot of data we haven’t been using. EMDI is an attempt to start reorganizing that data and make it more useful clinically.”

E-QUAL Network

E-QUAL builds upon CEDR by promoting learning and improvement initiatives. Physicians enrolling in E-QUAL engage in collaborative projects that tackle critical issues like stroke care, sepsis management, and the opioid crisis. This participation ensures that EDs nationwide not only meet benchmarks, but actively refine their practices.

“Some very technically savvy members of ACEP, who work in the quality arena, helped build the E-QUAL program,” said Dr. Augustine. “It goes beyond developing measures to teach physicians about the measures and how to implement them uniformly.”

E-QUAL’s framework includes a robust feedback mechanism, where participants can assess how changes in practice affect outcomes. This feedback is essential in making data actionable, enabling physicians to understand how even minor adjustments can lead to significant improvements. Participants earn improvement activity credit for the Centers for Medicare and Medicaid Services Merit-based Incentive Payment System (MIPS) and a certificate of completion, along with real-time benchmarking data.

Physicians who enroll also receive an introduction into quality improvement and best practice implementation.

The E-QUAL Network enrollment period is now open for this year’s initiatives—sepsis, opioid and alcohol use disorder, and venous thromboembolism.

Revolutionizing Data Analysis

Dr. Epstein and Dr. Augustine pointed out that ACEP wasn’t the first to build a registry for its specialty. Oncology, trauma surgery, and anesthesiology established registries years before, paving the way for improvements in patient care and safety. Unlike trauma centers or oncology departments, which often relied on dedicated personnel to manually extract and submit data, emergency medicine implemented a fully digital approach. This placed emergency medicine at the forefront of modern data management.

By focusing on automation and scalability, the EMDI ensures seamless integration with existing hospital systems.

The digital nature of the EMDI also enables it to evolve rapidly, incorporating new technologies like artificial intelligence and machine learning. Experts say these tools have the potential to revolutionize data analysis, offering insights that were previously unimaginable.

“When we’re able to discern that certain EDs are doing a better job, we can identify what high-performing institutions do differently and spread those practices nationwide,” Dr. Epstein said. “Patients get better care, and emergency physicians make decisions supported by robust data.”

The EMDI’s success depends on active participation. Whether contributing data, engaging in collaborative networks like EQUAL, or advocating for specialty-specific measures, every physician has a role to play. As federal mandates continue to evolve, the ability to report and utilize data will directly affect reimbursement, quality metrics, and public health outcomes. Dr. Epstein and Dr. Augustine said in order for emergency medicine to thrive, it must remain at the forefront of data innovation.

As the EMDI continues to innovate—new registries such as the Hospital and Observation Medicine Registry are in development—its influence extends beyond emergency medicine and individual EDs to shape national and global standards for acute care.

Dr. Augustine emphasized that “data must come back to the bedside and assist in individual patient encounters. That’s how we grow, improve our tools, and ultimately serve our patients better.”

Mr. Scheid is ACEP’s Communications Director.