Identification of patients with coronary heart disease: meeting regulatory standards vs. improving overall care.

Acute myocardial infarction (AMI) patients can be identified prospectively by troponin-I (TnI) result monitoring and retrospectively by ICD-9 diagnosis coding. Prospective identification is needed for interventions, while retrospective identification is required for regulatory reporting. Prospective approaches can identify patients with a reasonable degree of accuracy, but they cannot always predict ICD-9 coding for that condition. Our approach focuses on prospective identification of patients with CHD to improve their care. Meeting regulatory standards is a secondary goal.