Rheumatology Informatics System for Effectiveness: A National Informatics‐Enabled Registry for Quality Improvement

Abstract

Background The Rheumatology Informatics System for Effectiveness (RISE) is a national electronic medical record (EMR)-enabled registry. RISE passively collects data from EMRs 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 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 on a biologic or targeted synthetic DMARD at their last encounter, and 66.7% were receiving a non-biologic DMARD. Examples of quality measures include: 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 is ongoing and RISE is available to the research and clinical communities to advance rheumatology.

High Adherence to System‐Level Performance Measures for Rheumatoid Arthritis in a National Early Arthritis Cohort Over Eight Years

“…The ACR Rheumatology Clinical Registry (18) was used by rheumatologists for the Physician Quality Reporting System and demonstrates that registries are useful vehicles for quality monitoring and reporting. Recently, the ACR has developed the Rheumatology Informatics System for Effectiveness (RISE) registry (19). RISE passively extracts electronic medical records (EMR) data from participating practices for quality measurement and reporting.…”

Leveraging the electronic health record to improve quality and safety in rheumatology

“…This is problematic because detection and extraction of PRO and disease activity measures from these unstructured fields is labor-intensive and error-prone. [21]…”

A new era of quality measurement in rheumatology: electronic clinical quality measures and national registries

“…These include the development of standards for eCQM development, such as the Quality Data Model, successes in aggregating data from different EHR systems into national registries, such as the Rheumatology Informatics System for Effectiveness (RISE), and the application of methods such as natural language processing to enhance the accuracy of eCQM data collection. 7,8 …”

“…8 RISE passively extracts data to populate eCQMs from individual practices, aggregates and analyzes these data centrally, submits eCQMs to federal agencies for quality reporting, and feeds performance information back to clinicians using a web-based interface. The registry has made headway in addressing some of the challenges of interoperability that have previously made sharing quality measure performance data across health systems difficult.…”