Impact of Registry Use on Quality and Outcomes in Rheumatology (QORA)

项目总结/摘要 美国流变学学院于2014年启动了RISE注册。RISE是一个联邦资格 临床数据登记（QCDR），从参与提供者的EHR被动收集数据， 集中汇总和分析数据，并持续反馈质量措施的执行情况， 通过基于网络的仪表板进行实践。RISE已发展成为世界上最大的风湿病学注册中心之一。 世界上有200万患者，有2000万次接触。然而，需要研究来量化RISE的 对质量和结果的影响，并探讨其卫生信息技术基础设施 影响临床实践。建议的研究将采用混合方法来检查差异 在使用RISE注册表基于网络的仪表板，并探讨这种变化对质量的影响， 护理和临床结果。我们将重点介绍类风湿性关节炎（RA），最常见的炎性关节炎 影响了130万美国人，以及一个拥有几项国家认可的质量措施的地区。我们的中央 假设是参与并积极利用RISE上现有数据和工具， 随着时间的推移，仪表板会导致质量和成果的改善。注册表使用的拟议影响 质量和成果在流变学（QORA）项目的目标包括1）分析医生和 通过分析RISE仪表板使用模式中的大量日志数据， RISE数据仓库; 2）调查参与和参与RISE注册的影响， 护理质量和临床结局，以及3）确定重新设计RISE上可用工具的策略 仪表板，以提高其可用性和有效性，以提高当地的质量。为了最后一个目标，我们将 对不同地区的RISE用户进行一系列半结构化采访和实地观察 流变学的实践设置和以人为本的设计专家团队的工作。拟议工作 将使我们能够提供证据来改善RISE，并最大限度地提高其对护理质量和结果的影响 对风湿性疾病的人来说。该研究还将产生数据，以支持核心公共卫生优先事项， NIAMS：提高美国风湿病护理质量

PROJECT SUMMARY / ABSTRACT The American College of Rheumatology launched the RISE registry in 2014. RISE is a federally Qualified Clinical Data Registry (QCDR) that passively collects data from the EHRs of participating providers, aggregates and analyzes data centrally and continuously feeds back performance on quality measures to practices via a web-based dashboard. RISE has grown into one of the largest rheumatology registries in the world, with 2 million patients with 20 million encounters. However, research is needed to quantify RISE's impact on quality and outcomes and to explore the specific mechanisms by which its health IT infrastructure influences clinical practice. The proposed study will employ a mixed methods approach to examine variations in use of the RISE registry web-based dashboard and explore the consequences of this variation on quality of care and clinical outcomes. We will focus on rheumatoid arthritis (RA), the most common inflammatory arthritis affecting 1.3 million Americans, and an area with several nationally-endorsed quality measures. Our central hypothesis is that participation and active engagement with the data and tools available on the RISE dashboard leads to improvements in quality and outcomes over time. The proposed Impact of Registry Use on Quality and Outcomes in Rheumatology (QORA) project aims include 1) analyzing physician and practice-level variation in patterns of RISE dashboard use by analyzing the extensive audit-log data in the RISE data warehouse; 2) investigating the impact of participation and engagement with the RISE registry on quality of care and clinical outcomes, and 3) identifying strategies for redesigning tools available on the RISE dashboard to improve its usability and its effectiveness for local quality improvement. For this last aim, we will perform a series of semi-structured interviews and field observations with users of RISE in different rheumatology practice settings and work with a team of human-centered design experts. The proposed work will allow us to generate evidence to improve RISE and maximize its impact on quality of care and outcomes for people with rheumatic diseases. The study will also generate data to support a core public health priority for NIAMS: improving the quality of rheumatologic care delivery in the U.S.