Use and impact of registries for myocardial infarction on process of care and outcomes: Examples from Canada

Cardiovascular illnesses remain the leading causes of death in western society. Myocardial infarction, in particular, is responsible for major mortality, sickness, and disability, and moreover represents a significant economic burden. Yet many fundamental issues concerning this disease remain undefined. A national myocardial infarction registry would enable researchers to evaluate the system-wide effect of both current healthcare structures and practice patterns on outcomes, and measure accurately healthcare costs. This information would allow healthcare payers, administrators, and providers to determine where and how to implement change, and so develop rational healthcare policy. Better data could be used to bolster arguments regarding the need for increased funding of both patient care and research. The establishment of a clinically detailed registry of myocardial infarction that enrolled all afflicted patients nationwide would likely prove to be administratively cumbersome and prohibitively expensive. Nevertheless, there may be an opportunity to use administrative databases to develop a national overview of hospitalized and fatal cases of myocardial infarction, with linkage to existing disease-specific registries that provide clinical detail at a representative regional level. One example whereby registries can be used to help understand where and how to optimize process of care, and hence outcomes, is provided by the Nova Scotia Acute Myocardial Infarction Outcomes Monitoring Project. This partnership between government, healthcare providers, and industry is aimed at assessing and optimizing provincial patterns of care and outcomes associated with myocardial infarction.