Surgical Care and Outcomes Assessment Program Comparative Effectiveness Research

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DESCRIPTION (provided by applicant): The Surgical Care and Outcomes Assessment Program (SCOAP) is a voluntary, performance surveillance, sharing and feedback platform derived from clinical records. SCOAP improves quality by increasing adoption of evidence-based process of care measures and performing "real world" comparative effectiveness research (CER). In just four years, SCOAP was deployed across nearly all statewide hospitals. Versions of SCOAP exist for cardiac care, general surgical care, pediatric surgical care, and now vascular interventions (VI- SCOAP) for peripheral vascular disease. As a platform for both CER and improved adoption of CER-informed process of care measures for clinical quality improvement (QI), SCOAP is currently limited in scale by a lack of automated data gathering, linkage between data streams and connections to post-discharge and patient reported outcomes. Drawing information out of these different systems and linking them to other data sources for CER or QI requires an information technology solution that can interact with all available data systems and all types of data. We propose to deploy Amalga UIS" across the SCOAP Network to address the problem of inter-system connectivity by linking data systems in a common, framework. Amalga UIS" deployment within SCOAP will create automated data retrieval from each participating hospitals' varied electronic sources, doctor's offices and outpatient data streams. We will link automated clinical data with to administrative claims to track for all subsequent hospitalizations, vital status records for survival outcomes, healthcare payer claims datasets for outpatient encounters and medication utilization data, and point-of-care, longitudinal patient reported outcomes. The resulting SCOAP CER Translation Network (CERTN) will facilitate efficient CER as well as support SCOAP's QI initiatives around CER-driven process of care metrics. We will demonstrate the usability of the SCOAP CERTN Project for research and improved adoption of CER-informed process of care by using VI-SCOAP and comparing the treatment strategies of peripheral arterial disease and addressing procedural safety. Leveraging existing strengths of the SCOAP network and the VI-SCOAP registry with Microsoft's partnership, we propose several enhancements to improve our capability and scalability for longitudinal clinical and patient reported outcomes data collection. The SCOAP CERTN project will be a large-scale, real-world resource for CER based on clinical data using an automated data retrieval stream from diverse healthcare settings. This will greatly enhance existing SCOAP QI by delivering more comprehensive and timely data, and in relieving manual staff and resource burden to participating hospitals. SCOAP CERTN's initial CER focus will be in vascular surgery and interventions, but the project will be a gateway for investigators from all clinical disciplines to evaluate clinical outcomes, cost-impact, PROs and to translate evidence into QI. Importantly, surgical and interventional services span the continuum of healthcare conditions and SCOAP CERTN will have immediate capacity for investigators interested in almost any of AHRQ's priority conditions. PUBLIC HEALTH RELEVANCE: The SCOAP CERTN project will be a large-scale, real-world resource for CER based on clinical data using an automated data retrieval stream from diverse healthcare settings. SCOAP CERTN project's initial focus will be in vascular surgery and interventions, but this will be a gateway for investigators from across all clinical disciplines to evaluate clinical outcomes, cost-impact, patient reported outcomes and to translate evidence into clinical quality improvement. Surgical and interventional services span the continuum of healthcare conditions and SCOAP CERTN will have immediate capacity for investigators interested in almost any of AHRQ's priority conditions.