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

项目摘要/摘要 美国风湿病学会于2014年启动了RISE注册。Rise是一名联邦合格的 被动地从参与提供者的电子病历收集数据的临床数据注册处(QCDR)， 集中聚合和分析数据，并持续反馈有关质量指标的性能，以 通过基于Web的仪表板进行练习。RISE已经成长为世界上最大的风湿病登记处之一 世界上有200万患者，有2000万次就诊。然而，需要研究来量化Rise的 对质量和结果的影响，并探索其卫生信息技术基础设施 影响临床实践。拟议的研究将采用混合方法来检查差异。 使用RISE注册表基于Web的仪表板，并探讨这一变化对 护理和临床结果。我们将重点关注类风湿性关节炎(RA)，这是最常见的炎症性关节炎 影响着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，对数据和工具的参与和积极参与正在上升 随着时间的推移，仪表板会带来质量和结果的改进。注册表使用的拟议影响 风湿病的质量和结果(QORA)项目的目标包括1)分析医生和 RISE仪表板使用模式的实践层面的变化，通过分析 RISE数据仓库；2)调查参与和参与RISE登记对以下方面的影响 护理质量和临床结果，以及3)确定重新设计可用工具的策略 仪表板，以提高其可用性和有效性，以提高当地的质量改进。为了这个最后的目标，我们将 对不同的Rise用户进行一系列半结构化访谈和实地观察 风湿病实践设置，并与以人为中心的设计专家团队合作。拟议中的工作 将使我们能够产生证据来改善RISE并最大限度地提高其对护理质量和结果的影响 对于患有风湿病的人来说。这项研究还将产生数据，以支持以下核心公共卫生优先事项 NIAMS：提高美国风湿病护理服务的质量

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.