Dear Members of the AANS:
In this past year, the NeuroPoint Alliance (NPA) undertook a major restructuring effort to build upon the great gains that were made under the original NPA programs and the inaugural leadership of Dr. Robert Harbough. The main work product of this effort was a thorough strategic planning process, which was spearheaded by Dr. Shelly Timmons. As the organization and some of its registries mature and begin to yield the expected benefits for neurosurgery and its patients, it seemed the right time to reflect on what has been and for NPA to plan for what is to come.
During the strategic plan process, I was struck by the number of significant milestones the NPA has already achieved, of which we all should be proud.
The NPA has helped to objectively demonstrate the effectiveness of various therapies in specific patient populations in “real world” settings. In doing so, we have shown the power merging data and outcomes from clinicians in both the “academic” and “private practice” management of multiple neurosurgical procedures.
The NPA has disseminated those techniques nationally, along with quality reporting tools and processes to support quality improvement programs at the local level or our members. The operational acumen and resulting data credibility have been accepted – even embraced – by numerous important stakeholders, including large health care systems, government and private payers and regulatory bodies, as well as device manufacturers, all interested in the outcomes we generate caring for our patients.
These work efforts we have accomplished through the NPA have allowed us to form multiple cooperative relationships with colleagues in affiliated specialties and health care science (orthopedic surgery, neurology, radiology, radiation oncology). Collaboratively, working for the good of all patients suffering the spectrum of neurological conditions, no matter which specialty contributes to treatment, we can promote quality and effective care delivered in the most efficient way possible.
The NPA has formed partnerships with health care scientists to translate registry data to systematic quality improvement, facilitating the creation and dissemination of site-specific, risk-adjusted benchmarks for patient reported outcomes and utilization.
The NPA has taken a leading role nationally in the drive to clarify the non-research status of specialty-driven clinical registries with federal authorities. The NPA obtained Quality Outcomes Database (QOD)-specific guidance, a first in the nation, from OHRP and OCR that dramatically facilitated activities of all prospective national clinical registries.
Multiple centers are now using NPA registries as part of their clinical and business operations and not just for quality improvement. Applications across the country vary from advanced Quality Initiative projects, public reporting, payor negotiations and value-based contracting to direct physician-patient interactions using evidence-based decision support tools.
Data from NPA registries has supported the production of over 100 manuscripts. Each year, there are even greater numbers of abstracts and national presentations using data derived from our clinical data registry efforts.
Projects undertaken by the NPA have been focused on retrospective and prospective research driven by member needs and identified in the marketplace (Spondylolisthesis Study Group; Cervical Spine Project); by Industry and privately-funded research (SRS and RAD-PD); and for the development of robust and unparalleled cooperative research networks involving investigators around the nation (NVQI-QOD and ASR).
The NPA’s flagship registry – Quality Outcomes Database: Spine (QOD: Spine) – facilitated the participation of hundreds of neurosurgeons in community and academic settings in an unprecedented, shared data effort to help improve the quality and safety of spine care.
This year, the NPA grew that platform by entering into a partnership with the American Association of Orthopedic Surgeons (AAOS). The new registry – American Spine Registry (ASR) – serves both the neurosurgical and orthopedic specialties and offers spine patients a comprehensive look at treatments unavailable until now. This partnership leverages the clinical experience we have gleaned from QOD Spine, one of the largest spine surgical registry efforts to date, with the platform and experiences gained from the largest surgical base in the AAOS joint registry. The expanded ASR is already the largest national spine registry, turning it into the first national cooperative registry to routinely collect longitudinal patient-reported outcomes. In less than a decade of full operations, the NPA has developed one of the most productive collaborative endeavors in the history of the specialty.
I am particularly proud that the NPA team nationally, as well as the multiple QOD sites, with the administrative help from the AANS and the countless hours of the many neurosurgeon physician champions have led our specialty through the creation of novel, national data systems for tracking not only spine surgery, but also vascular surgery through our collaborative with the SNIS-QOD Vascular registry. We should be even more proud of the quality culture that seems to naturally emanate from these initiatives and the other projects that the NPA has tackled, including developing the first set of federally approved, specialty-specific quality measures allowing measurement of performance that matters to neurosurgeons and our patients.
While the NPA’s accomplishments are worthy of celebration, the potential for its future is even more exciting. Using the foundations that made QOD: Spine and Vascular so successful, the NPA is looking forward to the current launch of the Tumor Registry to deliver patient-reported outcome driven insights in the management of neuro-oncology procedures and protocols. Having these working platforms also allows us to provide infrastructure and support to other neurosurgical procedures where the cost of developing and maintaining stand-alone projects would not be viable. We at the NPA look forward to the continued delivery of programs that enrich and give insights into the quality-based procedures and outcomes neurosurgeons provide our patients.
Best regards,
John Joseph Knightly, MD, FAANS
Chair, NPA