Explicit physician referral of patients to cardiac rehabilitation has been shown to substantially increase the likelihood of patient enroll- ment (47,48). Although it could be argued that referral is the responsibility of a patient s primary physician or other members of the healthcare team, the writing committee believes that cardiac rehabilitation referral should be part of the comprehensive care of a patient undergoing PCI and should be the responsibility of the providers involved with that procedure, in a manner similar to treatment of dysli- pidemia. Referral during the index hospitalization for PCI is therefore optimal. The performance measure takes into account appropriate exclusions, such as medical non- suitability (e.g., history of comorbidities), patient prefer- ence, and lack of availability of a suitable program. This performance measure harmonizes closely with the corre- sponding measure from the ACCF/AHA/PCPI coronary artery disease performance measure set. In the future, broadening this measure to assess levels of participation on the basis of attendance, rather than simply referral, might be examined. 5.9. Regional or National PCI Registry Participation The writing committee believed strongly that every cath- eterization laboratory should participate in a national or regional PCI registry for benchmarking purposes. The bene ts of participating in a registry include the ability to JACC Vol. 63, No. 7, 2014 Nallamothu et al. February 25, 2014:722 45 ACC/AHA/SCAI/AMA-PCPI/NCQA compare the catheterization laboratory s outcomes with those of similar laboratories of comparable volumes, so that the laboratory staff understands their outcomes in relation to national or regional standards. We believe this measure will encourage more cardiac catheterization laboratories to participate in large multicenter databases and collaboratives to improve the evidence base to support quality efforts in PCI. 5.10. 