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

项目摘要/摘要

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.