International Circulation: Sure in some hospitals， it wasn’t a matter of negligence it was just that they were not aware? You were able to make them aware?
Jack Lewin:Exactly.
International Circulation:  They just didn’t know? So that is amazing， right?
Jack Lewin: It is really powerful when you gave people data about their performance， they change their performance. You know， we all think we are doing a great job， but until you know.
International Circulation: Sure.
Jack Lewin:Now we are moving the NCDR into the outpatient domain. So the community， the clinics and the doctors’ office will also be part of this measurement. And we can track the patients when they leave the hospital throughout their next years of life. That is important because we want to be able to do is to develop national surveillance system that tracts the improvement in cardiovascular diseases and looks for problems that need to be addressed. The interesting thing is this is being done by the American College of Cardiology profession of medicine not by government. And so we would suggest this kind of partnership would be nice to have in other countries.

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