Rheumatology Informatics System for Effectiveness: A National Informatics-Enabled Registry for Quality Improvement
Rheumatology Informatics System for Effectiveness: A National Informatics-Enabled Registry for Quality Improvement
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DOI：
10.1002/acr.23089
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发表时间：
2016-12-01
影响因子：
4.7
通讯作者：
Kazi, Salahuddin
中科院分区：
文献类型：
--
作者：
Yazdany, Jinoos;Bansback, Nick;Kazi, Salahuddin
客观的。风湿病学信息有效性系统 (RISE) 是一个支持国家电子健康记录 (EHR) 的注册表。 RISE 被动地从参与实践的 EHR 收集数据，提供先进的质量测量和数据分析能力，并满足国家质量报告要求。在这里，我们报告了注册中心的架构和初始数据，并演示了如何使用 RISE 来提高护理质量。方法。 RISE 是经过医疗保险和医疗补助服务中心认证的合格临床数据注册中心，允许在未经患者个人知情同意的情况下收集数据。我们分析了 2014 年 10 月 1 日至 2015 年 9 月 30 日期间的数据，以描述 RISE 中初始实践和患者的特征。我们还分析了类风湿性关节炎 (RA) 患者的药物使用情况以及多项质量指标的表现。结果。 55 个地点的 312 名临床医生向 RISE 贡献了数据； 72% 参加团体执业，21% 参加单独执业，7% 参加更大的卫生系统。网站提供了 239,302 人的数据。在 RA 亚组中，34.4% 的患者在最后一次就诊时正在服用生物药物或靶向合成缓解病情抗风湿药物 (DMARD)，66.7% 的患者正在接受非生物 DMARD。质量衡量的例子包括 55.2% 的人记录了疾病活动评分，53.6% 的人记录了功能状态评分，91.0% 的人在去年服用了 DMARD。结论。 RISE 为提高风湿病护理质量提供了关键基础设施，并且是生成新知识的独特数据源。数据验证和绘图正在进行中，RISE 可供研究和临床社区使用，以推进风湿病学的发展。
Objective. The Rheumatology Informatics System for Effectiveness (RISE) is a national electronic health record (EHR)enabled registry. RISE passively collects data from EHRs of participating practices, provides advanced quality measurement and data analytic capacities, and fulfills national quality reporting requirements. Here we report the registry's architecture and initial data, and we demonstrate how RISE is being used to improve the quality of care.Methods. RISE is a certified Centers for Medicare and Medicaid Services Qualified Clinical Data Registry, allowing collection of data without individual patient informed consent. We analyzed data between October 1, 2014 and September 30, 2015 to characterize initial practices and patients captured in RISE. We also analyzed medication use among rheumatoid arthritis (RA) patients and performance on several quality measures.Results. Across 55 sites, 312 clinicians contributed data to RISE; 72% were in group practice, 21% in solo practice, and 7% were part of a larger health system. Sites contributed data on 239,302 individuals. Among the subset with RA, 34.4% of patients were taking a biologic or targeted synthetic disease-modifying antirheumatic drug (DMARD) at their last encounter, and 66.7% were receiving a nonbiologic DMARD. Examples of quality measures include that 55.2% had a disease activity score recorded, 53.6% a functional status score, and 91.0% were taking a DMARD in the last year.Conclusion. RISE provides critical infrastructure for improving the quality of care in rheumatology and is a unique data source to generate new knowledge. Data validation and mapping are ongoing and RISE is available to the research and clinical communities to advance rheumatology.