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Registries and Rheumatology Quality

Kristen McNiff, MPH  |  Issue: June 2010  |  

Registries

Well-developed registries have the potential to assess healthcare quality and inform practice innovations. Beyond internal applications, such as population management, registries with a collaborative, quality-improvement component can provide provider- or practice-specific and comparative benchmarking data. This audit–feedback aspect of quality improvement—including analysis and reporting of specific quality measures—has been the main impetus for many medical societies’ registry development.

Indeed, many of our sister medical societies have been active in this area over the past decade (or, in some cases, considerably longer), establishing and running registries that enable their members to realize various benefits. The Society for Thoracic Surgery, American College of Cardiology (ACC), American College of Surgeons, and ASCO among others, all maintain registries. Perhaps more relevant to rheumatology, the American Academy of Orthopedic Surgeons recently announced the launch of the American Joint Replacement Registry, with plans to start accepting data in fall 2010.

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The ACR’s Approach

The ACR has taken a thoughtful approach to entering the registry arena; we’ve been neither an innovator nor an early adopter. After taking the time to learn from the successes and failures of our sister societies, the ACR launched the Rheumatology Clinical Registry (RCR) in July 2009. This was a major step for the ACR, and an important addition to the member benefits.

Although the ACR’s registry infrastructure is still in development, the RCR served as an effective mechanism for reporting to the CMS Physician Quality Reporting Initiative (PQRI) immediately upon launch. In 2009, 240 members used the RCR for PQRI reporting. The RCR process is more efficient than CMS’ alternate claims-based reporting methodology, and offers the benefit of immediate performance reporting.

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Simply submitting codes on claims, or entering data into the RCR as a purely administrative exercise, does not form the basis of practice quality improvement. Some argue that PQRI barely qualifies as a quality exercise, and certainly the program provides limited data points for most specialists. Even with these limitations, however, some members using the RCR for PQRI reporting have identified areas in need of improvement. As we continue to develop the RCR—including the data elements, data sources, and measures reported—we do so with the vision of a comprehensive resource to inform practice innovation.

The field of rheumatology can benefit collectively as the RCR expands. Imagine, for instance, ACR Annual Scientific Meeting sessions that showcase real-world data regarding concordance with ACR guideline recommendations, among other metrics of the quality of care. Imagine reports from targeted practice improvement projects, with results and tools that can be implemented in clinical settings nationwide. The recent annual meeting of our colleagues at the ACC was peppered with these types of sessions featuring results of ACC registry efforts.

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