The Professional and Social Benefits of Clinical Registries

March 6, 2018

Clinical registries can assist medical practices with their quality initiatives, but also provide a high-tech community, says one expert.

At the crossroads of near-universal use of EHRs and quality care initiatives calling for numerous patient data, clinical registries are becoming vital repositories of health care information.

Whether focused on a specific disease state, procedure, or even on the performance of a medical device, there is no shortage of registries for interested practices to submit data to. And with the CMS Quality Payment Program (QPP) and commercial payer programs providing incentives for participation, they are gaining more acceptance.

At the annual Healthcare Information and Management Systems Society (HIMSS) conference, Seth Blumenthal, MBA, director of data and innovation for health outcomes organization, PCPI, will discuss how medical practices can benefit from participation in these registries, despite lingering interoperability issues.

Blumenthal recently spoke to Physicians Practice to preview of his session, “Clinical Data Registries: Solving for Interoperability,” scheduled for Friday, March 9, from 12-1 p.m. Pacific.

Physicians Practice: What are the benefit to medical practices (especially smaller private practices) of clinical registries?

Seth Blumenthal: Medical practices of all sizes - but particularly at smaller, private practices - the physicians, clinical leaders, and administrative leaders are under tremendous strain these days because of all the burdens they face. Amid many regulatory burdens, they are just trying to provide the best patient care they can, with an appropriate and efficient use of resources. They have a number of issues, particularly centered around the use of their EHR, but there are a couple of different aspects around the use of clinical data registries that might impact them.

They should participate in a registry, the physicians particularly, because it is a good way for them to participate in a value-based payment program, such as the QPP or perhaps programs from private payers that have negotiated a risk-sharing contract with their group with incentives for registry participation.

There are benefits for participating in a registry, particularly a registry that has achieved the Qualified Clinical Data Registry (QCDR) status - those that have passed a certification process by CMS that allows them to be used for participation in the QPP. QCDRs make available to physicians performance measures that …are approved directly by CMS.

Fundamentally, registries support measures that clinicians and physicians care about and should be relevant to their practice. I know that there has been issues with some specialties having more or less of a selection of measures that are relevant to their practice. [However], the primary benefit is that if the registry is a QCDR, simply by participating on behalf of their patients, physicians can participate in the QPP and hopefully choose measures that are relevant to their practice. They then increase their chance of being successful in terms of their financial performance as per the incentives.

[As a physician], I’m going to get feedback about my performance relative to those like me, perhaps in my own practice or in other practices like mine in my region of the country, perhaps my state and then nationally.

PP: How can these practices access such registries amid current interoperability issues?

SB: So part of [interoperability issues are] due to the design of the EHR and part of it is due to the increased regulatory burden / documentation burdens. What you don’t want to do is participate in a registry in a way that increases that burden. What registry programs are trying to do, as much as possible, is work with EHR vendors so [that the] data they need to populate their registries can be automatically extracted from the EHR and transmitted to the registries. It’s pulling the relevant information, processing it and forming it, and translating it in a way that it will make sense to the registry, given how the registry is storing specific data.

One reason you can use registry data to make comparisons across performance across a wide area is because registries are careful about vetting and quality checks and formatting data that they put into the registry into a form.

One of the interoperability issues we are focusing on at PCPI and other organizations we collaborate with is to try and help the industry increase the percent of data that go into registries where they can be collected automatically.

We are not there yet with automatic transfer of information, so part of my work is to help the industry do that better and many others are doing similar work.

PP: What do you want attendees of your session to walk away with / what advice can you give non-attendees at HIMSS18?

SB: I’d say to all clinicians, those who attend my session and those who don’t, if there is an opportunity to participate in a registry that fits your practice and is in your specialty, it will give you access to not only the kinds of feedback I talked about, but also access to a community.

Registries are national, professional communities of practice. People around the country who are in your specialty, who are passionate about being the best specialty they can be. What I think a lot of clinicians find is participating in a registry results in meeting others like them that are all facing the same kind of burdens, all trying to solve the same kind of problems, focusing on the same kind of issues, and don’t have to solve for those issues alone.

They have the benefit of a national network of friends and colleagues, so there is a social, human element of participation available for the taking.