The mission of the AQI is to develop and maintain an ongoing registry of case data that helps anesthesiologists assess and improve patient care. Organize the registry so that anesthesiology practice groups desire to submit their case information, and so that individual anesthesiologists, practice groups, researchers, and professional societies find the data useful for improving the quality of care.

The Anesthesia Quality Institute (AQI) was created by action of the ASA House of Delegates in October, 2008. The AQI is a separately incorporated organization, with its own Board of Directors. The vision of the AQI is 'to become the primary source of information for quality improvement in the clinical practice of anesthesiology.'

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.

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.

Data contributed to the AQI will be held in the strictest confidence, and will be analyzed and reported in the aggregate only. Anesthesia practices contributing data will receive periodic 'benchmarking' reports from the AQI, comparing their process and outcomes to a peer group of similar practices. 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.'

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

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

Questions on the AQI and NACOR may be directed to Richard P. Dutton, M.D., M.B.A, AQI Executive Director (r.dutton@asahq.org), or Jill Mlodoch, AQI Administrator (j.mlodoch@asahq.org). You may also obtain more information by registering on the AQI Web site.

Your practice contact will be provided with a log in and password(s) via email upon execution of the AQI participation agreements. Enter your log in and password to access the practice survey.

The AQI Resource Page may be accessed on the AQI Web site and provides additional information on anesthesia facts, measurements and definitions for perioperative data, and a presentation on the value of participating in the Registry.

The Registry will collect 4 types of data including practice demographics, case specific data, outcomes data and risk adjustment 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.

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.

The AQI accepts at minimum, the billing data collected through your software vendor, and basic demographic data about your practice, providers and facilities. This document describes the AQI Minimal Data Set in detail. We expect that the minimum requirements for AQI participation will increase over time, as more practices get involved and as all providers become more 'digital' in their data collection.

No, the AQI will accept any and all digitized data you collect. Our IT professionals will do the necessary translations to prepare your data for upload to the Registry. You will be asked to provide the name of your software vendor(s), and either a sample of the data you collect or an exported report (excluding patient identifiers).

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.

The 2010 participation fee shall be waived for participants contributing data to the AQI Registry (of at least the quality defined by the AQI 2010 Minimal Data Set).  Participant will be entitled to receive the AQI quarterly and annual summary reports, as well as the participant specific reports appropriate to participant’s practice. 

Beginning January 1, 2011, participant will be required to pay a fee annually to receive AQI reports.  The fee will be $500 per anesthesiologist in the group, but will be waived for anesthesiologists who are members of the American Society of Anesthesiologists.  The fee calculation for the group's participation in the AQI in 2011 will be based on the last quarter of data submitted by the group in 2010.

Ideally, weekly or monthly billing data submission is desired. At minimum, billing data should be submitted quarterly.

The Registry will be generating quarterly benchmarking reports to contributing practices. Each practice group will also receive aggregated data in electronic format (most likely Excel) that they can manipulate to their own needs. For example, an individual practice may want to sort data by provider or care team, etc.

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.

You may email Jill Mlodoch, AQI Administrator, and express your interest in joining the AQI. Or you may also register your interest on the AQI Web site.

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

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.

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.

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.

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.

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.

Ideally, 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.