Welcome to ACEP’s Clinical Emergency Data Registry
CEDR (Clinical Emergency Data Registry) is the first Emergency Medicine (EM) specialty-wide registry and was developed by ACEP.
CEDR has the capability and functionality to do the following:
- Measure EM outcomes
- Identify practice patterns and trends
- Improve the quality of acute care
- Meet and exceed QPP/ MIPs quality reporting
- Eliminate and/ or increase payer revenue
In addition, the CEDR registry ensures that emergency physicians, rather than other parties, are identifying practices that work best for them.
CEDR currently offers a choice of 44 Quality Measures and 30 Improvement Activities to fulfill MIPS quality reporting requirements.
Take a Closer Look – Dr. Stephen Epstein
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Why Should You Participate?
Instead of being mired in an alphabet soup of reporting requirements, CEDR allows for a single data capture to fulfill the requirements of multiple programs, making your quality measure reporting more efficient. The healthcare environment is transitioning from volume-based to value-based payment for care. The CEDR registry will ensure that emergency physicians, rather than other parties, are identifying what practices work best and for whom.
The CEDR registry is developed under a sophisticated information technology infrastructure with ongoing development to support emerging quality needs of ACEP members and will be implemented in a phased-in manner over the next year in terms of the number of participating EDs, scope and functionality.
Through the aggregation and organization of data on clinical effectiveness, patient safety, care coordination, patient experience, efficiency and system effectiveness, CEDR will provide clinicians with a definitive resource for informing and advancing the highest quality of emergency care.
Advantages: CEDR - An Enhancement to Traditional Claims-Based Reporting
A Physician Friendly System
The CEDR registry is designed to be physician-friendly. With little data entry burden to emergency clinicians or ED staff, clinical and patient data will be extracted, transformed and loaded into CEDR from the ED’s electronic health record system, practice management system, or administrative data system.
Approved by CMS
ACEP has been approved by the Centers for Medicare and Medicaid Services (CMS) for CEDR to serve as a “qualified clinical data registry” or QCDR, to help emergency physicians and clinicians meet CMS’ Quality Payment Program (QPP) / Merit-Based Incentive Payment Program reporting and regional and national certification requirements.
Evidence-Based Decision Making
National and comparative data generated by the CEDR registry will support evidence-based shared decision making and guideline-informed physician practices.
Comparative Quality Benchmarking
CEDR will provide participating emergency clinicians with feedback regarding their individual- and/or ED-level performance on a range of process and outcome quality measures, benchmarked against their peers at national and regional levels.
For government policy-makers, the CEDR registry will provide further understanding around clinical effectiveness, patient safety, care coordination, patient experience, efficiency and system effectiveness.
About Qualified Clinical Data Registries (QCDR)
- The Merit-Based Incentive Payment Plan (MIPS) is one of the two tracks for the CMS Quality Payment Program (QPP). QCDRs are one of the submission methods for MIPS.
- A QCDR is an entity that collects clinical data from MIPS-eligible clinicians to accurately and successfully report it to CMS on their behalf.
- The idea behind QCDRs was for specialty providers to create specialty-specific QCDR.
- CEDR is such a QCDR developed by American College of Emergency Physicians for the Emergency Physicians.
A QCDR measure
- A measure that isn’t in the annual list of MIPS measures for the applicable performance period.
- A measure that may be in the annual list of MIPS measures but has major differences in how it’s submitted by the QCDR.
- A QCDR can customize their version of the CAHPS for MIPS measure (for example, by supporting only a subset of the Survey Summary Measures (SSMs)). The QCDR measure version of the CAHPS for MIPS survey would also take non-Medicare beneficiaries into consideration.
A ‘Qualified Registry’ vs. a ‘QCDR’
A qualified registry (QR) can collect and submit quality data to CMS but is limited to submission of only CMS-developed measures. The QCDR reporting option is more beneficial than use of a qualified registry provides the important benefit of developing and hosting specialty-specific measures approved by CMS for reporting and obtaining maximum potential benefit on quality and potential reimbursement.
Frequently Asked Questions
What is CEDR?
Developed by ACEP, the Clinical Emergency Data Registry (CEDR), is the first Emergency Medicine specialty-wide registry, to measure acute care quality, outcomes, practice patterns and trends in emergency care. The CEDR registry ensures that emergency physicians, rather than other parties, are identifying what practices work best for them.
What are the benefits of participating in CEDR?
- Protection of revenue and ability to gain bonus.
- MACRA/MIPS compliance.
- Establish national benchmarks for EM-specific quality measures.
- Assists you to easily fulfill the ABEM (American Board of Emergency Medicine) MOC (Maintenance of Certification) requirement.
- Facilitate appropriate emergency care research.
How do I access my Dashboard?
- Click Your CEDR Dashboard at the top of this page ↑ to proceed.
- After you click on the CEDR Dashboard Icon it will take you to the login page where you can login with your ACEP ID and Password.
How are the different performance categories scored?
What is Quality Performance Category Scoring?
For the 2018 performance period:
- The weight of the Quality performance category is 50% of your MIPS final score.
- Quality measures that can be scored against a benchmark will receive between 3 and 10 points as measure achievement points.
- Quality measures that don’t have a benchmark or do not meet the case minimum (e.g., a denominator of 20) will receive 3 points.
What does the onboarding and implementation process for CEDR look like?
- Complete the Interest Form
- After beginning conversation with a CEDR intake specialist, complete the more Detailed Application.
- Complete the Contracting Process (this includes a Business Agreement, Clinical Participation Agreement, Billing company agreement and/or Hospital contract agreement).
- Move into technical implementation with your CEDR account owner at ACEP who will guide you through selection of data connection method (Pull, Push, or FHIR), data extraction, and data communication and mapping process.
- Check Sample Data
- Run Query on Quality Payment Program Measures for extracted data.
- Delivery of dashboard.
- Ongoing refresh and review of dashboard enhancements.
What is the cost of CEDR participation?
A standardized Data Processing fee is applied, which is relative to the annual visit volume for each particular ED.
Additionally, an Annual Provider Fee for each participating provider (including advanced practice/midlevel providers), though this fee is waived if a provider is or becomes an ACEP members, provider groups that enroll for 100% club membership, and members of associated organizations (i.e.: SEMPA) for advanced practice/midlevel providers.
More information on the cost of CEDR participation will be provided during the contracting process.
CEDR Sign Up Demo
Past Webinars and Educational Resources
With the CEDR Qualified Clinical Data Registry (QCDR) option in 2018, emergency physicians and clinicians may choose to report the following QCDR Measures, QPP Measures, and eCQMs to receive credit for MIPS quality reporting. Quality Improvement (QI) measures and EQUAL measures are not eligible to be reported for MIPS Quality Reporting through CEDR.
QCDR Measures Supported
|ACEP19||Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 18 Years and Older||Efficiency & Cost Reduction||Process|
|ACEP20||Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 2 Through 17 Years||Efficiency & Cost Reduction||Process|
|ACEP21||Coagulation Studies in Patients Presenting with Chest Pain with No Coagulopathy or Bleeding||Efficiency & Cost Reduction||Process|
|ACEP22||Appropriate Emergency Department Utilization of CT for Pulmonary Embolism||Efficiency & Cost Reduction||Process|
|ACEP24||Pregnancy Test for Female Abdominal Pain Patients||Patient Safety||Process|
|ACEP25||Tobacco Screening and Cessation Intervention for ED Patients with Cardiovascular and/or Pulmonary Conditions||Community -Population Health||Process|
|ACEP29||Sepsis Management: Septic Shock: Repeat Lactate Level||Effective Clinical Care||Process|
|ACEP30||Sepsis Management: Septic Shock: Lactate Clearance Rate ≥ 10%||Effective Clinical Care||Outcome|
|ACEP31||Appropriate Foley Catheter Use in the Emergency Department||Patient Safety||Process|
|ACEP32||ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients||Patient Experience of Care||Outcome|
|ACEP33||ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in Supercenter EDs (80+)||Patient Experience of Care||Outcome|
|ACEP35||ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in High Volume EDs (60k-79,999)||Patient Experience of Care||Outcome|
|ACEP36||ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in Average Volume EDs (40k- 59,999)||Patient Experience of Care||Outcome|
|ACEP37||ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in Moderate Volume EDs (20k- 39,999)||Patient Experience of Care||Outcome|
|ACEP38||ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in Low Volume EDs (19,999 and less)||Patient Experience of Care||Outcome|
|ACEP39||ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in Freestanding EDs||Patient Experience of Care||Outcome|
|ACEP40||ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients||Patient Experience of Care||Outcome|
|ACEP41||ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in Supercenter EDs (80k +)||Patient Experience of Care||Outcome|
|ACEP43||ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in High Volume EDs (60k-79,999)||Patient Experience of Care||Outcome|
|ACEP44||ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in Average Volume EDs (40k-59,999)||Patient Experience of Care||Outcome|
|ACEP45||ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in Moderate Volume EDs (20k-39,999)||Patient Experience of Care||Outcome|
|ACEP46||ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in Low Volume EDs (19,999 and less)||Patient Experience of Care||Outcome|
|ACEP47||ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in Freestanding EDs||Patient Experience of Care||Outcome|
|ACEP48||Sepsis Management: Septic Shock: Lactate Level Measurement, Antibiotics Ordered, and Fluid Resuscitation||Effective Clinical Care||Process|
QPP Measures Supported
|QPP66||Appropriate Testing for Children with Pharyngitis||Efficiency & Cost Reduction||Process|
|QPP76||Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections||Patient Safety||Process|
|QPP91||Acute Otitis Externa (AOE): Topical Therapy||Effective Clinical Care||Process|
|QPP93||Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy Avoidance of Inappropriate Use||Efficiency & Cost Reduction||Process|
|QPP116||Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis||Efficiency & Cost Reduction||Process|
|QPP187||Stroke and Stroke Rehabilitation: Thrombolytic Therapy (tPA)||Effective Clinical Care||Process|
|QPP254||Ultrasound Determination of Pregnancy Location for Pregnant Patients with Abdominal Pain||Effective Clinical Care||Process|
|QPP255||Rh Immunoglobulin (Rhogam) for Rh-Negative Pregnant Women at Risk of Fetal Blood Exposure||Effective Clinical Care||Process|
|QPP317||Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented||Community/Population Health||Process|
|QPP326||Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation Therapy||Effective Clinical Care||Process|
|QPP331||Adult Sinusitis: Antibiotic Prescribed for Acute Sinusitis (Overuse)||Efficiency and Cost Reduction||Process|
|QPP332||Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin With or Without Clavulanate Prescribed for Patient with Acute Bacterial Sinusitis (Appropriate Use)||Efficiency and Cost Reduction||Process|
|QPP333||Adult Sinusitis: Computerized Tomography for Acute Sinusitis (Overuse)||Efficiency and Cost Reduction||Process|
|QPP415||Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 18 Years and Older||Efficiency & Cost Reduction||Process|
|QPP416||Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 2 Through 17 Years||Efficiency & Cost Reduction||Process|
|QPP419||Overuse Of Neuroimaging For Patients With Primary Headache And A Normal Neurological Examination||Efficiency & Cost Reduction||Efficency|
ECQMs Measures Supported
|ECQM66||Appropriate testing for children with pharyngitis||Efficiency & Cost Reduction||Process|
|ECQM317||Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented||Community/Population Health||Process|
QI Measures Supported
|ACEPQI01||Sepsis Management: Septic Shock: Blood Cultures Ordered||Effective Clinical Care||QI/Process|
|ACEPQI02||Emergency Medicine: Appropriate Use of Imaging for Recurrent Renal Colic||Efficiency: Overuse||QI/Process|
|ACEP26||Sepsis Management: Septic Shock: Lactate Level Management||Effective Clinical Care||QI/Process|
|ACEP27||Sepsis Management: Septic Shock: Antibiotics Ordered||Effective Clinical Care||QI/Process|
|ACEP28||Sepsis Management: Septic Shock: Fluid Resuscitation||Effective Clinical Care||QI/Process|
*QI measures are not eligible for 2018 MIPS Quality Reporting through CEDR Download QI Measures PDF
EQUAL Measures Supported
|EQUAL1||CT utilization for back pain|
|EQUAL2||EQUAL 2 XRay utilization for back pain|
|EQUAL3||MRI utilization for back pain|
|EQUAL4||CT utilization for minor head injury|
|EQUAL5||CT yield for minor head injury|
|EQUAL6||CT for renal colic|
|EQUAL7||CT for syncope|
|EQUAL8||CT utilization for pulmonary embolism|
|EQUAL9||CT yield for pulmonary embolism|
|EQUAL10||Chest pain admission rate|
|EQUAL11a||Disposition among ED visits for chest pain -Discharges|
|EQUAL11b||Disposition among ED visits for chest pain - Observation|
|EQUAL11c||Disposition among ED visits for chest pain - Inpatient Admission|
|EQUAL11d||Disposition among ED visits for chest pain – Transfers|
|EQUAL12a||Stress testing and imaging among ED visits for chest pain - Stress ECG|
|EQUAL12b||Stress testing and imaging among ED visits for chest pain - Stress Nuclear, SPECT|
|EQUAL12c||Stress testing and imaging among ED visits for chest pain - Stress Nuclear, PET|
|EQUAL12d||Stress testing and imaging among ED visits for chest pain - Stress Echocardiogram|
|EQUAL12e||Stress testing and imaging among ED visits for chest pain - Coronary CT Angiography|
|EQUAL12f||Stress testing and imaging among ED visits for chest pain - Stress Cardiac MR|
For more information on the EQUAL program, visit the Equal Website
*EQUAL measures are not eligible for 2018 MIPS Quality Reporting through CEDR.
Call for performance measure topics
ACEP’s Clinical Emergency Data Registry (CEDR) is soliciting new topics for performance measure development from March 28-April 27th. All ACEP members are invited to submit a topic relevant to emergency medicine. Submissions for consideration will be reviewed and prioritized based on strength of evidence, opportunity for quality improvement, and impact on the specialty.
- Your group provides CEDR with information on group size, number of hospital EDs served, annual ED census, number of emergency clinician providers and contact information for each ED.
Participation Agreement and Business Associate Agreement
- The Participation Agreement is a vehicle to create common understanding and agreement of participation and expectations. It also includes the Business Associate Agreement and the Data Use Agreement for HIPPA compliance.
Initial Data Capture
- All data extract and upload activity is fully encrypted and complies with HIPAA guidelines. We have successfully mapped data from over 50 different EHR systems.
RCMS / EHR Mapping
- This step involves Group Administrator participation. A Client Account Manager (CAM) will engage the group in discussion to ensure accurate data mapping.
- The Client Account Manager will coordinate calls with the group to review performance reports and answer questions. Typically during this step, the group will get access to an interactive dashboard. The dashboard gives the group the ability to query their data, see measure performance across different measures for multiple locations and providers.
Internship at American College of Emergency Physicians (ACEP)
ACEP is looking to engage Graduate/Senior level college students for a semester of management and IT trainee/internship. The ACEP Internship is one option for experiential learning and is available to selected students enrolled at a participating University in a degree-granting program or have recently completed one.
Installation of the Registry Practice Connector (RPC)
- Our standard integration method involves the installation of a piece of software known as the Registry Practice Connector which runs as a Windows service. This service is integrated with the Revenue Cycle Management (RCM) system and/or Electronic Health Record (EHR) database using read-only credentials for the back end RDBMS (i.e. Microsoft SQL Server, etc.).
- The Registry Practice Connector allows us a great deal of flexibility in mapping data elements required by the registry and usually requires no involvement of the RCM &/or EHR vendor beyond providing read-only credentials to the database in situations that require it.
- Our goal is to have minimal impact and require little if any work effort on the part of the RCM / EHR vendor and/or the group IT staff.
- In situations where RPC installation is not possible, the registry can accept data files from the participating site or the RCM / EMR vendor via the data push method. Files are typically transferred via secure file transport protocol (SFTP). However, we encourage participation thru the data pull method via the Registry Practice Connector to reduce the burden of data collection and reporting on the ED providers and RCM firms.