A registry can be used as a stand-alone application supporting care in a paper office environment, as a stand-alone application aligned with an EHR system, or as an integrated component of your EHR system. The electronic registry should not be confused with an EHR system because a registry only manages specific information relevant to a selected patient population or condition. In contrast, an EHR system collects and stores comprehensive medical and billing records. It is also important to note that, unlike the EHR system, the registry does not represent a legal documentation of care. Essentially, the registry serves as a computer application facilitating secondary use of patient health information.
Some EHR systems currently provide a patient registry or population management module as part of the integrated solution; however, it is far more common that large health organizations and practices use a complementary system or spend a great deal of time and money working with the EHR vendor to customize a solution. This is most often the case for specialties like rheumatology. Most EHR vendors do not have qualified support staff to develop and maintain these systems in a way that provides a complete solution.
Finding the best registry solution for your practice can be a challenge. Some EHR purchasers have worked closely with EHR vendors to customize their systems to offer some of the needed functionality. However, EHR customization is time intensive and requires significant technical experience.
The Importance of Aggregating Data and Benchmarking
Practice- and institution-specific registries have several important limitations when they are used for quality-monitoring purposes.
- Conducting consistent and thorough analyses is challenging. Good quality metrics use carefully specified numerators, denominators, and exclusions to ensure valid and reliable data reports.
- The sample size for any individual physician or practice may be too small to draw meaningful conclusions.
- Results of analyses may be difficult to interpret in the absence of national comparative or benchmarking data.
These limitations of local registries can largely be overcome by contributing data to multi-institutional or national registries. These larger efforts have the resources to conduct data analysis and quality reporting to provide comparative and benchmarking data that give context to a practice’s own data, and to aggregate data to achieve sample sizes that allow for valid conclusions regarding care processes and patient outcomes.
240 of Your Colleagues Submitted for PQRI Using the RCR—Did You?
Did you know that you can use the RCR to satisfy the PQRI requirements necessary to receive bonus incentive payments for registry reporting, rather than employing the claims-based reporting that users have found so onerous in past years? To learn more about the RCR, visit www.rheumatology.org/practice, or e-mail Itara Barnes at [email protected].