Exploring Strategies to Improve Cardiac Arrest Survival Proceedings of a Workshop (2017) / Chapter Skim
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2 Building a National Cardiac Arrest Surveillance System
2 Building a National Cardiac Arrest Surveillance System
Pages 19-36
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report Strategies to Improve Cardiac Arrest Survival: A Time to Act the committee stated that "given the large health burden of cardiac arrest, a national responsibility exists to facilitate dialogue about cardiac arrest that is informed by comprehensive data collection and timely reporting and dissemination of information" (IOM, 2015, p.
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data, to help increase federal and state accountability for current system performance and promote actions to im prove cardiac arrest outcomes. Specifically, CDC should • establish a cardiac arrest surveillance system for the nation that includes IHCA and OHCA data in pediatric and adult populations; • make data publicly available through appropriate mechanisms to enable comparisons across datasets in order to increase public awareness about cardiac arrest incidence and treatments, improve accountability for emer gency medical services system and health care system performance, and target interventions that will reduce disparities and improve patient outcomes; • identify and adopt standardized definitions, criteria, and metrics (e.g., age, gender, race and ethnicity, socioeconomic status, and primary language)
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often take precedence over specific areas of surveillance, such as cardiac arrest or stroke. More broadly, Merritt described barriers that will face the resuscitation field as it attempts to establish a comprehensive national cardiac arrest surveillance system.
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In order to advance national cardiac arrest surveillance efforts, Merritt said the resuscitation field will need to establish strong public− private partnerships and develop a strategy to leverage and expand existing surveillance efforts. In a hypothetical scenario in which Merritt received $10 million in unrestricted funds to advance comprehensive cardiac arrest surveillance, he suggested dedicating resources to a few priority areas.
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Regardless of the approach used, this goal would need to be carried out in a meaningful and coordinated way, Merritt concluded. The National Highway Traffic Safety Administration Perspective Noah Smith, National Highway Traffic Safety Administration The goal of the National Emergency Medical Services Information System (NEMSIS)
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Smith said, there are many pros and few cons to combining these efforts and resources. He offered NEMSIS as a prehospital dataset that could serve as a valuable data source for cardiac arrest surveillance efforts.
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Smith was also asked to consider the hypothetical scenario in which he received $10 million in unrestricted funds to advance comprehensive cardiac arrest surveillance. He suggested first conducting a pilot test of a state-level sudden cardiac arrest registry under the most progressive, well-established state health information exchange.
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Albert noted that the group was tasked with identifying research barriers, considering innovative solutions, developing recommendations to advance research efforts, and establishing short- and long-term goals for preventing sudden cardiac death in the general population. The working group divided its deliberations across four subgroups and areas of focus, which resulted in the development of the following five recommendations: • NHLBI Working Group Recommendation 1: Sudden cardiac death should be classified as a reportable condition -- a recom mendation, noted Albert, that is similar to recommendations com ing from the resuscitation field for cardiac arrest.
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to identify and confirm cases and subtypes of sudden cardiac death. This would require data elements that cap ture information on possible risk factors that preceded the death (e.g., age, health status, comorbid conditions)
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SOURCE: Presented by Michael Frankel, July 11, 2016, A Dissemination Workshop on the Report Strategies to Improve Cardiac Arrest Survival: A Time to Act.
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In part, the successes of the Coverdell Stroke Registry in Georgia can be credited to the collaborative efforts among the American Heart Association, the American Stroke Association, the Joint Commission, and participating hospitals, said Frankel. If existing registries (e.g., CARES, Get With the Guidelines)
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Cognitive Computing as a Cardiac Arrest Surveillance Strategy Laura Langmade, IBM Watson Health Watson Health is a cognitive computing system that is capable of understanding, reasoning, and learning, according to Laura Langmade. For health care, structured data include easily quantifiable data points that can be found in EHRs, such as vital signs and lab results, whereas unstructured data refers to blocks of text found in published literature, social media, and images.
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Barriers and Lessons Learned When considering how elements from cognitive computing and technological advances could be applied to the development of a cardiac arrest registry, Langmade encouraged developers to think about how the data are generated and collected, how those data will be mapped and moved across systems, how the data can be scrubbed of technically implausible information, and how to accomplish ongoing monitoring and validation of the data. Langmade identified three main barriers that will need to be overcome in order to design a national registry: the diversity of data sources, the volume of data, and the variety of data.
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Both groups considered different options to enhance a cardiac arrest surveillance system. There is no definition of an optimal registry, stated Becker.
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Becker and Atkins noted that data entry and reporting must not be onerous, and any efforts to expand surveillance would need to be cost-effective. Atkins underscored the importance of defining a minimum dataset with optional elements that could be added, depend BOX 2-2 Examples of Potential Partners for Building a National Cardiac Arrest Surveillance System • Federal Government Agencies: Centers for Disease Control and Preven tion, Department of Health and Human Services, Department of Homeland Security, Food and Drug Administration, National Highway Traffic Safety Administration, National Institutes of Health, and others.
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2016. NHLBI Sudden cardiac death prevention working group: Focus on preven tion in the general population.
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2016. Sudden Cardiac Death Prevention.
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