DIRECT DIFFERENCE TEAM

Andrea Romo, BSN, RN

Clinical Liaison

Andrea Romo is a Registered Nurse and healthcare quality professional with extensive experience in clinical data abstraction, hospital quality reporting, clinical measure implementation, and operational leadership. She brings a strong combination of clinical expertise and quality reporting knowledge to her work supporting hospitals and health systems across the United States. Her experience includes implementing large-scale abstraction services, supporting a broad range of quality measures and clinical registries, and partnering with hospital leaders to align services, education, and implementation strategies with organizational quality goals.

Andrea earned her Bachelor of Science in Nursing from the University of Texas in 2011. Her clinical background includes emergency nursing, critical care, cardiac care, and stroke, including experience as an ICU Director. She previously held CCRN certification during her bedside nursing career before transitioning into quality management and clinical data abstraction. At Direct Difference, Andrea has progressed from Clinical Data Abstractor to Account Manager, Senior Account Manager, and Clinical Liaison, expanding her responsibilities in client management, clinical quality, and implementation.

Andrea has extensive expertise in CMS quality measures, including sepsis, and serves as a key resource for interpreting and communicating CMS measure updates.

She translates complex specifications and reports changes into practical education for abstraction teams, providers, and hospital clients. Her experience includes developing and implementing CMS CDAC validation protocols for the Inpatient and Outpatient Quality Reporting Programs and supporting hospitals in challenging inaccurate validation findings and associated annual payment update reductions. She has also helped identify printed-chart and data-presentation issues that could affect validation outcomes and has supported hospitals across multiple states in maintaining Get With The Guidelines Honor Roll and Gold achievement recognition.

In her role as a Clinical Liaison and Multi-Clinical Measure Lead with Direct Difference, Andrea partners with healthcare organizations to support accurate abstraction, regulatory compliance, and quality improvement. She provides clinical and operational guidance, helps clients navigate complex measure requirements, and supports education related to documentation and performance improvement. From individual case review to large health-system implementations, Andrea brings a practical, client-focused approach to connecting clinical practice, reliable quality data, and meaningful improvement opportunities.

Tracy Robison, LPN

Cardiac Clinical Liaison

Tracy Robison is a cardiovascular healthcare professional with over 20 years of experience spanning cardiac critical care, care coordination, quality improvement, registry management, data analytics, and clinical leadership. Her career reflects a strong commitment to improving cardiovascular outcomes through evidence-based practice, accurate data capture, and collaborative program development.

She brings extensive expertise in the American College of Cardiology’s National Cardiovascular Data Registry (ACC NCDR), as well as other national and state cardiovascular quality initiatives. Her background includes nearly two decades in cardiac critical care, 15 years as a cardiovascular care coordinator, and leadership roles across emergency and cardiovascular service lines, where she helped strengthen care processes, improve documentation, and support quality performance.

Tracy has held several leadership roles within cardiovascular quality and education, including service on the NCDR Education Committee and the NCDR Annual Meeting Planning Committee.

She has also collaborated with the American Heart Association’s Ohio Mission: Lifeline program to develop protocols and support regional systems of care for cardiovascular patients.

A dedicated educator and mentor, Tracy has provided training for nursing and ancillary staff on evidence-based practices related to acute coronary syndrome (ACS) and acute myocardial infarction (AMI). She has also contributed cardiovascular research, publications, and abstract presentations, helping translate clinical and registry data into meaningful quality improvement opportunities.

In her current role as Cardiac Clinical Liaison with Direct Difference, Tracy supports healthcare organizations in improving cardiac registry performance, strengthening data integrity, and advancing sustainable cardiovascular quality initiatives. She partners with teams to identify opportunities for improvement, promote best practices, and support high-quality cardiovascular care.