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FREQUENTLY ASKED QUESTIONS


About AQI and NACOR

  1. Who are the stakeholders for the AQI?
     
  2. What are some of the advantages of registry participation?
     
  3. What is NACOR?
     
  4. What are the sources of NACOR data?
     
  5. Is there any cost associated with participating in the registry?
     
  6. Who may I contact if I have questions or need more information on the AQI and NACOR?

 

Data Confidentiality

  1. What protections has AQI put in place to protect privacy and anonymity of NACOR data?
     
  2. Who has access to the AQI database?
     
  3. Are Registry participants considered 'covered entities' under HIPAA?
     
  4. Will fully-identified PHI be required for submission?
     
  5. What are the HIPAA implications of sending PHI to the Registry?

 

Data Collection

  1. What types of data will the registry capture?
     
  2. What is the minimum data that must be provided in order to participate in the registry?
     
  3. Is there a specific type of billing software or specific data requirements for participation in the registry?
     
  4. Are there any special requirements if my practice has multiple sites/facilities?
     
  5. How often should data be uploaded to the registry?
     
  6. As a registry participant, is IRB compliance a requirement?

 

Becoming an AQI participant

  1. Once I have notified AQI of my interest, what happens next?
     
  2. What are the steps for becoming a registry participant?

 

Practice survey

  1. As a participating contributor to NACOR, how do I log in to complete the practice demographics survey located on the AQI web site?
     
  2. When completing the Practice Survey, what ID numbers should be used for providers and facilities?
     
  3. Should locum tenens be included as Providers on the AQI practice survey?

 

Practice Reports

  1. How will the registry report data?
     
  2. What reports and measures will registry participants receive? How often will reports be generated and in what format?
     
  3. Will the AQI consider custom report requests from participants?

 

Mulitcenter perioperative outcomes (MPOG) and the AQI

  1. Can I be a member of either organization without being a member of the other?
     
  2. Do I need separate institutional approvals for sending data to each of these organizations?
     
  3. How much does it cost to become a member of MPOG and AQI?
     
  4. Who owns the data after I send it to MPOG or AQI?
     

ANSWERS

About AQI and NACOR


  1. Who are the stakeholders for the AQI?

    The relationship chart depicts the relationship between AQI and its stakeholders.

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  2. What are some of the advantages of registry participation?

    AQI data will be useful for activities ranging from faculty education to outcomes measurement to emerging federal efforts to ensure performance improvement. Click here for a slide presentation on the value of AQI participation.

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  3. What is NACOR?

    NACOR stands for National Anesthesia Clinical Outcomes Registry. NACOR is the data warehouse that will eventually capture the approximately 25 million anesthetics and millions of pain clinic procedures performed each year by anesthesiologists in the United States.

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  4. What are the sources of NACOR data?

    The flow chart illustrates the data flow from NACOR into the AQI.

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  5. Is there any cost associated with participating in the registry?

    The annual fee is $500 per anesthesiologist in the group, but is waived for anesthesiologists who are members of the American Society of Anesthesiologists (ASA).

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  6. Who may I contact if I have questions or need more information on the AQI and NACOR?

    Questions on the AQI and NACOR may be directed to Jill Mlodoch, AQI Registry Manager or Deborah Novi, AQI Administrator. You may also obtain more information by registering on the AQI Web site.

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Data Confidentiality

  1. What protections has AQI put in place to protect privacy and anonymity of NACOR data?

    Data uploaded to the registry will be de-identified before it is uploaded to the database. Direct patient identifiers will not be part of the Registry, and facilities and providers will assign their own codes to providers and facilities. Nothing published by the AQI will ever directly identify a patient, provider or facility without their express permission.

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  2. Who has access to the AQI database?

    Access to the AQI database is limited to AQI employees only. The registry is hosted on servers in a secure server room at ASA headquarters.

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  3. Are registry participants considered 'covered entities' under HIPAA?

    Yes, registry participants are considered 'covered entities' under HIPAA. The HIPAA Privacy Rule provides federal protections for personal health information (PHI) held by 'covered entities.' At the same time, the Privacy Rule is balanced so that it permits the disclosure of PHI needed for patient care and other important purposes.

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  4. Will fully-identified PHI be required for submission?

    No, PHI is not required for NACOR reporting. The registry is accepting a 'limited data set' as defined by HIPAA. A 'limited data set' contains fields such as date of birth and zip code but does not include fields such as the patient's name or medical record number. HIPAA permits 'limited data set' disclosure with a data use agreement in effect between AQI and the registry participant.

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  5. What are the HIPAA implications of sending PHI to the registry?

    Participation in the NACOR is primarily for the purpose of 'health care operations.' HIPAA defines 'health care operations' to include quality assessment and improvement activities, including outcomes evaluation. The mission of the NACOR is to develop and maintain an ongoing registry of case data that helps anesthesiologists assess and improve patient care. PHI may be disclosed for these purposes with a Business Associate agreement in effect between the AQI and the participant. The HIPAA Privacy Rule allows business associates to provide data aggregation related to 'health care operations.' While NACOR is not currently collecting PHI, we would be permitted to do so in the future.

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Data Collection

  1. What types of data will the registry capture?

    The registry will collect 4 types of data including practice demographics, case specific data, outcomes data and risk adjustment data.  We understand that your practice may have some or all of this data and that is perfectly acceptable.

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  2. What is the minimum data that must be provided in order to participate in the registry?

    Our vision is to accept electronic data from every practice in the United States regardless of size or level of digitization.  The minimum level of data required to participate in AQI is practice demographics (self-reported through the AQI website) and case specific data from the practice billing software.  Every anesthesia practice has this information available.   

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  3. Is there a specific type of billing software or specific data requirements for participation in the registry?

    The AQI will accept any and all digitized data you collect. AQI has already worked with our Preferred Vendors to develop data extracts for upload to the Registry.  If your practice uses one of our Preferred Vendors, the bridge is already built.  Vendors not listed will need to submit data according to AQI's format specifications.  The AQI team is available for questions from you and/or your vendor to facilitate an extract that meets AQI specifications. 

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  4. Are there any special requirements if my practice has multiple sites/facilities?

    There are no special requirements. You will participate in the registry as one entity and you will assign unique codes to each facility for your own identification purposes.

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  5. How often should data be uploaded to the registry?

    Data is uploaded on a monthly basis.

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  6. As a registry participant, is IRB compliance a requirement?

    No, the data submitted to the NACOR does not involve human subject research (such as clinical trials), so IRB compliance is not necessary. The main purpose of the data collected by the registry is for health care quality improvement and not research projects.

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Becoming an AQI participant

  1. Once I have notified AQI of my interest, what happens next?

    You will be sent more information via email along with links to the AQI agreements that need to be signed before official participation begins.

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  2. What are the steps for becoming a registry participant?

    You may email Deborah Novi, AQI Administrator, and express your interest in joining the AQI. Or you may also register here.

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Practice Survey

  1. As a participating contributor to NACOR, how do I log in to complete the practice demographics survey located on the AQI web site?

    Your practice contact (AQI Champion) will be provided with a user name and password upon execution of the AQI participation agreements. Enter your user name and password to access the practice survey.  The AQI Champion has the ability to assign additional logins and permissions by accessing the USERS box on the Members Only page of the AQI website.  

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  2. When completing the practice survey, what ID numbers should be used for providers and facilities?

    You will want to match the provider/facility numbers used in your billing software. These are the numbers that you will later use when uploading case specific data to NACOR.

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  3. Should locum tenens be included as providers on the AQI practice survey?

    Locum tenens do not need to be included as providers. The AQI system will automatically cross reference case data uploads against Providers and input a record for any missing provider(s). As a cross check, the practice may access the survey and edit their provider list.  Locum tenens and per diems may be classified in the survey drop down as "other."

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Practice Reports

  1. How will the registry report data?

    Data contributed to the AQI will be held in the strictest confidence, and will be reported in the aggregate only.  Anesthesia practices contributing data will have online access to their practice report through the AQI Members Only web portal.  Practice reports will mirror the data the practice uploads to the registry along with NACOR national benchmarks where available.  For more specific uses, such as allowing individual contributors to assess and improve patient care, the AQI will request permission of the provider or practice first, and will limit disclosure to only those with a 'need to know.'

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  2. What reports and measures will registry participants receive? How often will reports be generated and in what format?

    Participant reports are available via the AQI website by logging into the Members Only area on the home page.  Practice reports are accessed under the reports button and provide aggregate NACOR data along with data submitted by the participant.  Reports may be filtered (where applicable) to provide more specific data on a provider, facility or anesthesia case.

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  3. Will the AQI consider custom report requests from participants?

    Custom reports will be considered on a case-by-case basis. Additional fees may be applicable depending on the time and resources allocated to performing the request.

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Mulitcenter Perioperative Outcomes (MPOG) and the AQI

  1. Can I be a member of either organization without being a member of the other?

    Answer: Yes. To be a full MPOG member you need to have implemented an AIMS and have 10,000 cases entered into the MPOG dataset. You also need to have institutional IRB approval for the research work you will be doing with the MPOG data. Other requirements can be found on the MPOG website. To be a participant in AQI you need to complete a data sharing agreement and allow practice data meeting at least minimal standards to be entered into the AQI dataset. If you are an MPOG member, you may have your AIMS data directly sent to the AQI dataset, if you so desire. All data in both databases is de-identified.

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  2. Do I need separate institutional approvals for sending data to each of these organizations?

    Answer: Yes. You need to complete a data use agreement for MPOG and a separate one for AQI. These are contracts that need to be signed by your organization and either MPOG or AQI. The agreements are similar. As a member of AQI you must also complete the agreement to have your data placed in the National Anesthesia Clinical Outcomes Registry (NACOR). To be a full member of MPOG you must have your institution approved by a site IRB to allow you to send data to the MPOG data repository and ultimately receive data from MPOG for your individual research proposals.

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  3. How much does it cost to become a member of MPOG and AQI?

    MPOG membership is "free" but it does require resources at your institution to assist in the technical operations of transmitting data. The entrance "fee" for full MPOG membership is 10,000 cases into the data repository. MPOG will be using grant money to fund its further development. AQI membership is similar. You will need to commit some resources in your practice to facilitate data transfer. The AQI participation fee to receive practice reports is $500 annually per anesthesiologist in the group, but is waived for anesthesiologists who are members of the American Society of Anesthesiologists (ASA). Custom data searches and custom reports can be requested, but may require funding to complete.

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  4. Who owns the data after I send it to MPOG or AQI?

    MPOG is a data repository housed at the University of Michigan. All the data any institution sends to the MPOG data repository always remains the property of the originating institution. It is held in the repository so that it can be shared with other institutions given IRB approval and approval of the MPOG Board for that specific study. At that point the specific data fields being requested will be made available to the individuals who have received approval for their research project. Aggregated AQI data – which is all de-identified – belongs to the AQI for purposes of national quality management reporting and creation of process and outcome benchmarks. However the AQI will never report data from individual hospitals, practices or providers without their express permission. AQI data will also be available for academic use, but will require IRB approval from the requestor’s institution and endorsement by the AQI Data Use Committee. If such a request would include data submitted by joint AQI/MPOG participants, then approval of the MPOG Data Use Committee will also be required.

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