Abstract 265: Million Hearts TM and the PINNACLE Registry ® : Preliminary Data

Introduction: In September 2011, the Centers for Medicare & Medicaid Services and the Centers for Disease Control launched the Million Hearts campaign - a national public health initiative with the goal of reducing the number of heart attacks and strokes suffered in the US by 1 million over the next 5 years. Multiple federal agencies and private health care institutions have committed to become Million Hearts partners and bring their resources to bear in order to achieve this goal. The Million Hearts goal will be reached by the substantial reduction of dietary sodium and trans fats and by improving the “ABCS” of clinical prevention: Aspirin use for indicated conditions, Blood pressure control, Cholesterol treatment, and Smoking cessation counseling or medications. These four clinical performance measures are within the ken of practicing physicians and are readily measured in the American College of Cardiology’s (ACC) PINNACLE Registry. As a Million Hearts partner, the ACC pledged to provide data and engage in performance improvement initiatives to increase compliance with the four clinical measures. In this study, we compared compliance rates from PINNACLE to the Million Hearts baseline estimates for the nation and to their 2017 cardiovascular goals. Methods: The PINNACLE Registry contains data from more than 2.5 million outpatient encounters recorded over the past four years - representing approximately 800,000 discrete patients. Around 1,000 providers electronically submit data to PINNACLE and receive quarterly performance reports. Data queries determined PINNACLE provider compliance with analogs of the four Million Hearts performance measures. Results: see attached jpg Conclusion: Baseline performance measures in PINNACLE are favorable compared to the Million Hearts initial national estimates and 5-year goals. Million Hearts goals are population-level targets based on national survey data whereas PINNACLE patients are, by definition, in care, so some elevation of rates in the latter cohort is to be expected. There is, however, room for improvement in three of the four PINNACLE baseline performance measures. Concordant with the plans of the Million Hearts executive and scientific leadership, initial improvement efforts developed by the ACC will be directed toward improvement in blood pressure control of patients in the PINNACLE Registry. As the Million Hearts initiative moves forward, we can undertake formal efforts to learn from the higher rates of measure adherence and performance seen in cardiology practices by using top PINNACLE sites as a source for modular best practices around the ABCS.