The national neurosurgery quality and outcomes database and neuropoint alliance: Rationale, development, and implementation

Patient care data will soon inform all areas of health care decision making and will define clinical performance. Organized neurosurgery believes that prospective, systematic tracking of practice patterns and patient outcomes will allow neurosurgeons to improve the quality and efficiency and, ultimately, the value of care. In support of this mission, the American Association of Neurological Surgeons, in cooperation with a broad coalition of other neurosurgical societies including the Congress of Neurological Surgeons, Society of Neurological Surgeons, and American Board of Neurological Surgery, created the NeuroPoint Alliance (NPA), a not-for-profit corporation, in 2008. The NPA coordinates a variety of national projects involving the acquisition, analysis, and reporting of clinical data from neurosurgical practice using online technologies. It was designed to meet the health care quality and related research needs of individual neurosurgeons and neurosurgical practices, national organizations, health care plans, biomedical industry, and government agencies. To meet the growing need for tools to measure and promote high-quality care, NPA collaborated with several national stakeholders to create an unprecedented program: the National Neurosurgery Quality and Outcomes Database (N²QOD). This resource will allow any US neurosurgeon, practice group, or hospital system to contribute to and access aggregate quality and outcomes data through a centralized, nationally coordinated clinical registry. This paper describes the practical and scientific justifications for a national neurosurgical registry; the conceptualization, design, development, and implementation of the N²QOD; and the likely role of prospective, cooperative clinical data collection systems in evolving systems of neurosurgical training, continuing education, research, public reporting, and maintenance of certification.