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Published in: Surgery Today 11/2014

01-11-2014 | Review Article

Challenges and prospects of a clinical database linked to the board certification system

Authors: Hiroaki Miyata, Mitsukazu Gotoh, Hideki Hashimoto, Noboru Motomura, Arata Murakami, Ai Tomotaki, Norimichi Hirahara, Minoru Ono, Clifford Ko, Tadashi Iwanaka

Published in: Surgery Today | Issue 11/2014

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Abstract

In Japan, the National Clinical Database (NCD) was founded in April 2010 as the parent body of the database system linked to the board certification system. Registration began in 2011, and to date, more than 3,300 facilities have enrolled and more than one million cases are expected to enroll each year. Given the broad impact of this database initiative, considering the social implications of their activities is important. In this study, we identified and addressed issues arising from data collection and analysis, with a primary focus on providing high-quality healthcare to patients and the general public. Improvements resulting from NCD initiatives have been implemented in clinical settings throughout Japan. Clinical research using such database as well as evidence-based policy recommendations can impact businesses, the government and insurance companies. The NCD project is realistic in terms of effort and cost, and its activities are conducted lawfully and ethically with due consideration of its effects on society. Continuous evaluation on the whole system is essential. Such evaluation provides the validity of the framework of healthcare standards as well as ensures the reliability of collected data to guarantee the scientific quality in clinical databases.
Literature
2.
go back to reference Glickman SW, Baggett KA, Krubert CG, Peterson ED, Schulman KA. Promoting quality: the health-care organization from a management perspective. Int J Qual Health Care. 2007;19:341–8.PubMedCrossRef Glickman SW, Baggett KA, Krubert CG, Peterson ED, Schulman KA. Promoting quality: the health-care organization from a management perspective. Int J Qual Health Care. 2007;19:341–8.PubMedCrossRef
3.
go back to reference Ikegami N, Yoo BK, Hashimoto H, Matsumoto M, Ogata H, et al. Japanese universal health coverage: evolution, achievements, and challenges. Lancet. 2011;378(9796):1106–15.PubMedCrossRef Ikegami N, Yoo BK, Hashimoto H, Matsumoto M, Ogata H, et al. Japanese universal health coverage: evolution, achievements, and challenges. Lancet. 2011;378(9796):1106–15.PubMedCrossRef
4.
go back to reference Iwanaka T, Miyata H, Okubo S. Significance of National Clinical Database. Japn J Clin Med: Nippon-Rinsho. 2011;69(Sup 3):625–30 (in Japanese). Iwanaka T, Miyata H, Okubo S. Significance of National Clinical Database. Japn J Clin Med: Nippon-Rinsho. 2011;69(Sup 3):625–30 (in Japanese).
5.
go back to reference Iwanaka T, Miyata H, Okubo S, Tomotaki A. Principles of National Clinical Database. Clin Surg: Rinsho-Geka. 2012;67:742–5 (in Japanese). Iwanaka T, Miyata H, Okubo S, Tomotaki A. Principles of National Clinical Database. Clin Surg: Rinsho-Geka. 2012;67:742–5 (in Japanese).
6.
go back to reference Okubo S, Miyata H, Hashimoto H, Gotoh M, Murakami A, et al. National Clinical Database, Japan (NCD): department registration and data entry. Clin Surg: Rinsho-Geka. 2012;67:746–51 (in Japanese). Okubo S, Miyata H, Hashimoto H, Gotoh M, Murakami A, et al. National Clinical Database, Japan (NCD): department registration and data entry. Clin Surg: Rinsho-Geka. 2012;67:746–51 (in Japanese).
7.
go back to reference Mori R, Takemi K, Fineberg HV. Science and consensus for health policy making in Japan. Lancet. 2012;379(9810):12–3.PubMedCrossRef Mori R, Takemi K, Fineberg HV. Science and consensus for health policy making in Japan. Lancet. 2012;379(9810):12–3.PubMedCrossRef
8.
go back to reference Joint Committee on Educational Evaluation; Sanders JR (chair). The program evaluation standards: how to assess evaluations of educational programs, 2nd edn. Thousand Oaks: Sage Publications; 1994. Joint Committee on Educational Evaluation; Sanders JR (chair). The program evaluation standards: how to assess evaluations of educational programs, 2nd edn. Thousand Oaks: Sage Publications; 1994.
9.
go back to reference Institute of Medicine. Crossing the Quality Chasm: a New Health System for the 21st Century. Washington, DC: National Academy Press; 2001. Institute of Medicine. Crossing the Quality Chasm: a New Health System for the 21st Century. Washington, DC: National Academy Press; 2001.
10.
go back to reference Porter ME, Teisberg EO. How physicians can change the future of health care. JAMA. 2007;297:1003–111. Porter ME, Teisberg EO. How physicians can change the future of health care. JAMA. 2007;297:1003–111.
13.
go back to reference Jamtvedt G, Young JM, Kristoffersen DT, Thomson O’Brien MA, Oxman AD. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2003; 3: CD00259. Jamtvedt G, Young JM, Kristoffersen DT, Thomson O’Brien MA, Oxman AD. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2003; 3: CD00259.
14.
go back to reference Hall BL, Hamilton BH, Richards K, Bilimoria KY, Cohen ME, et al. Does surgical quality improve in the American college of surgeons national surgical quality improvement program. An evaluation of all participating hospitals. Ann Surg. 2009;250:363–76.PubMed Hall BL, Hamilton BH, Richards K, Bilimoria KY, Cohen ME, et al. Does surgical quality improve in the American college of surgeons national surgical quality improvement program. An evaluation of all participating hospitals. Ann Surg. 2009;250:363–76.PubMed
15.
go back to reference Berwick DM, James BC, Coye M. The connections between quality measurement and improvement. Med Care. 2003;41(1 suppl):I30–8.PubMed Berwick DM, James BC, Coye M. The connections between quality measurement and improvement. Med Care. 2003;41(1 suppl):I30–8.PubMed
16.
go back to reference Goetzel RZ, Ozminkowski RJ, Villagra VG, Duffy J. Return on investment in disease management: a review. Health Care Financ Rev. 2005;26:1–19.PubMed Goetzel RZ, Ozminkowski RJ, Villagra VG, Duffy J. Return on investment in disease management: a review. Health Care Financ Rev. 2005;26:1–19.PubMed
17.
go back to reference Miyata H, Motomura N, Murakami A, Takamoto S, Japan Cardiovascular Surgery Database. Effect of benchmarking projects on outcomes of coronary artery bypass graft surgery: challenges and prospects regarding the quality improvement initiative. J Thorac Cardiovasc Surg. 2012;143:1364–9.PubMedCrossRef Miyata H, Motomura N, Murakami A, Takamoto S, Japan Cardiovascular Surgery Database. Effect of benchmarking projects on outcomes of coronary artery bypass graft surgery: challenges and prospects regarding the quality improvement initiative. J Thorac Cardiovasc Surg. 2012;143:1364–9.PubMedCrossRef
18.
go back to reference Landon BE, Normand SL, Blumenthal D, Daley J. Physician clinical performance assessment: prospects and barriers. JAMA. 2003;290:1183–9.PubMedCrossRef Landon BE, Normand SL, Blumenthal D, Daley J. Physician clinical performance assessment: prospects and barriers. JAMA. 2003;290:1183–9.PubMedCrossRef
19.
go back to reference Schneider EC, Spstein AM. Influence of cardiac-surgery performance reports on referral practices and access to care-a survey of cardiovascular specialists. N Engl J Med. 1996;335:251–6.PubMedCrossRef Schneider EC, Spstein AM. Influence of cardiac-surgery performance reports on referral practices and access to care-a survey of cardiovascular specialists. N Engl J Med. 1996;335:251–6.PubMedCrossRef
20.
go back to reference Miyata H, Motomura N, Kondo MJ, Fushimi K, Ishikawa KB, et al. Toward quality improvement of cardiovascular surgery in Japan: An estimation of regionalization effects from a nationwide survey. Health Policy. 2009;91:246–51.PubMedCrossRef Miyata H, Motomura N, Kondo MJ, Fushimi K, Ishikawa KB, et al. Toward quality improvement of cardiovascular surgery in Japan: An estimation of regionalization effects from a nationwide survey. Health Policy. 2009;91:246–51.PubMedCrossRef
21.
go back to reference Vaughan-Sarrazin MS, Hannan EL, Gormley CJ, Rosenthal GE. Mortality in medicare beneficiaries following Coronary Artery Bypass Graft surgery in states with and without certificate of need regulation. JAMA. 2002;288:1859–66.PubMedCrossRef Vaughan-Sarrazin MS, Hannan EL, Gormley CJ, Rosenthal GE. Mortality in medicare beneficiaries following Coronary Artery Bypass Graft surgery in states with and without certificate of need regulation. JAMA. 2002;288:1859–66.PubMedCrossRef
23.
go back to reference Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med. 2009;360(10):961–72.PubMedCrossRef Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med. 2009;360(10):961–72.PubMedCrossRef
28.
go back to reference The United States President’s Commission. Final report of the ethical and legal problems in medicine and biomedical and behavioral research. Tokyo: Shinohara Publication; 1984 (in Japanese). The United States President’s Commission. Final report of the ethical and legal problems in medicine and biomedical and behavioral research. Tokyo: Shinohara Publication; 1984 (in Japanese).
31.
go back to reference Shahian DM, O’Brien SM, Filardo G, Filardo G, Ferraris VA, Haan CK, et al. The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1—coronary artery bypass grafting surgery. Ann Thorac Surg. 2009;88(1 Suppl):S2–22.PubMedCrossRef Shahian DM, O’Brien SM, Filardo G, Filardo G, Ferraris VA, Haan CK, et al. The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1—coronary artery bypass grafting surgery. Ann Thorac Surg. 2009;88(1 Suppl):S2–22.PubMedCrossRef
Metadata
Title
Challenges and prospects of a clinical database linked to the board certification system
Authors
Hiroaki Miyata
Mitsukazu Gotoh
Hideki Hashimoto
Noboru Motomura
Arata Murakami
Ai Tomotaki
Norimichi Hirahara
Minoru Ono
Clifford Ko
Tadashi Iwanaka
Publication date
01-11-2014
Publisher
Springer Japan
Published in
Surgery Today / Issue 11/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-013-0802-3

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