ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1998

A National Electronic Health Record-Enabled Registry in Rheumatology: The ACR’s Rheumatology Informatics System for Effectiveness (RISE)

Jinoos Yazdany1, Rachel Myslinski2, Melissa Francisco3, Nick Bansback4, Megan E. B. Clowse5, Deborah Collier6, Karen Law7, Katherine Liao8, Kaleb Michaud9, Esi Morgan-DeWitt10, Jim Oates11, Catalina Orozco12, Andreas Reimold13, Julia F Simard14 and Salahuddin Kazi15, 1University of California, San Francisco, San Francisco, CA, 2Governance & Ethics Specialist, Amer College of Rheumatology, Atlanta, GA, 3Practice, Advocacy & Quality, American College of Rheumatology, Atlanta, GA, 4Population and Public Health, The University of British Columbia, Vancouver, BC, Canada, 5Clinical Rheumatologist, Duke University Medical Center, Durham, NC, 6Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 7Emory University School of Medicine, Atlanta, GA, 8Division of Rheumatology, Immunology, and Allergy, Brigham & Women's Hospital, Boston, MA, 9Rheumatology & Immunology, University of Nebraska Medical Center and National Data Bank, Omaha, NE, 10Pediatric rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 11Medicine, Medical University of South Carolina, Charleston, SC, 12Arthritis Consultation Ctr, Dallas, TX, 13Rheumatology, VAMC, University of Texas Southwestern Medical Center, Dallas, TX, 14Division of Epidemiology, Health Research and Policy Department, and Division of Immunology & Rheumatology, Department of Medicine, Stanford School of Medicine, Stanford, CA, 15Internal Medicine/Rheumatology, UT Southwestern Medical Center, Dallas, TX

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: , , ,

Session Information

Date: Monday, November 9, 2015

Title: ACR Plenary Session II: Discovery 2015

Session Type: ACR Plenary Session

Session Time: 11:00AM-12:30PM

Title: A
National Electronic Health Record-Enabled Registry in Rheumatology: The ACR’s
Rheumatology Informatics System for Effectiveness (RISE)

Background/Purpose: In 2014, the ACR launched the Rheumatology
Informatics System for Effectiveness (RISE), a national electronic health
record (EHR)-enabled registry. RISE passively collects data from EHRs of
participating practices, provides advanced quality measurement and data
analytic capacities, and can be used to fulfill national quality reporting
requirements. Here we detail the characteristics of practices participating in
RISE, patient characteristics and performance on several nationally endorsed
quality measures.

Methods: RISE has achieved certification as a
Centers for Medicare and Medicaid Services (CMS) Qualified Clinical Data
Registry (QCDR), allowing collection of data on quality of care without
individual patient informed consent. Participating practices enter a Data Use
Agreement with the ACR, after which local data are mapped, validated and uploaded
regularly to the central registry. Practices can access an analytics dashboard
that allows review of up-to-date information on quality measures by provider
and practice as well as national benchmarks. RISE currently includes data on
numerous quality measures regarding rheumatoid arthritis (RA), drug safety,
osteoporosis prevention and treatment, low back pain, and preventive health
care (e.g. smoking, blood pressure management). We analyzed data between April
1, 2014 and March 31, 2015 to characterize initial practices and patients
captured in RISE.  We also calculated
performance on several RA quality measures recently endorsed by the National
Quality Forum (DMARD use, disease activity measurement, functional status
measurement).

Results:   During the dates
examined, RISE included data on 184,858 patients, including 49,205 with RA
(Table).  Two hundred five clinicians
across 39 sites contributed data to RISE; 72% of clinicians were in a group
practice, 25% were solo practitioners and 4% were part of a larger health
system. Characteristics of patients in RISE are summarized in the Table. For
the subset of patients with RA, 50.7% of patients had a disease activity score
recorded, 53.2% had a functional status score recorded, and 82.1% were taking a
DMARD, as defined by national quality measures.  

Conclusion: The ACR has launched a national EHR-enabled registry
that aims to provide critical infrastructure for improving quality of care in
rheumatology, to fulfill national performance reporting requirements, and to
serve as a unique data source to generate new knowledge regarding rheumatic
disease. Data validation and mapping is ongoing and RISE will be available to
both the research and clinical community to use to advance rheumatology. 

Table 1.  Baseline characteristics of
patients in the ACR’s RISE national registry.

Characteristic

Total N

(N = Distinct Patient)

Age at last encounter, mean (SD)

59 (± 16.1)

Sex

 

          Female, n (%)

138,748 (75.1%)

          Male, n (%)

46,106 (24.9%)

          Missing, n (%)

4 (0.002%)

Race, n (%)

 

          White

114,252 (61.8%)

          Black

14,765 (8.0%)

          Asian

2,816 (1.5%)

          American Indian/Alaskan Native

2,989 (1.6%)

          Native Hawaiian/Pacific Islander

84 (0.05%)

          Other

19,703 (10.7%)

          Missing

29,260 (15.8%)

Insurance/Payer type (at last encounter), n (%)

 

          Medicare

72,731 (39.3%)

          Medicaid

6,584 (3.6%)

          Commercial

12,7159 (68.8%)

          Other

14,975 (8.1%)

          Missing

25,200 (13.6%)

Selected Diagnoses (ICD9 code at last encounter), n (%)

 

Rheumatoid arthritis (ICD 9 714.0, 714.1, 714.2, 714.3 714.81)

49,205 (26.6%)

          Knee osteoarthritis (ICD9 715.16, 719.46)

33,824 (19.3%)

          Sjogren’s syndrome (ICD9 370.4, 710.2, 730.2)

11,762 (6.4%)

          Systemic lupus erythematous (ICD9 710.0,695.4)

11,720(6.3%)

          Gout (ICD9 274.xx, 984.9)

7,160 (4.1%)

          Spondyloarthropathy (ICD9 720.xx, 696.0))

4,306 (2.3%)

          Systemic sclerosis (ICD9 710.1)

2,062 (1.1%) 

          Vasculitis (ICD9 446.0, 446.1, 446.2, 446.4, 446.5, 446.7, 686.1, 287.0

1805(0.98%)

          Sarcoidosis (ICD9 135)

1169 (0.6%)

Smoking, n (%)  (last encounter)

 

          Never

107,578 (61.21%)

          Current

18,394 (10.47%)

          Former

34,608 (19.69%)

          Missing

11,613 (6.61%)

Blood pressure, mmHg, mean (SD) (last encounter)

 

          Systolic

125.28 (±15.92)

          Diastolic

75.18 (±9.68)

          Diastolic>90 OR Systolic> 140

24,916 (14.18%)

Disclosure: J. Yazdany, None; R. Myslinski, None; M. Francisco, None; N. Bansback, None; M. E. B. Clowse, UCB Pharma, 5; D. Collier, None; K. Law, None; K. Liao, None; K. Michaud, None; E. Morgan-DeWitt, None; J. Oates, None; C. Orozco, None; A. Reimold, None; J. F. Simard, None; S. Kazi, None.

To cite this abstract in AMA style:

Yazdany J, Myslinski R, Francisco M, Bansback N, Clowse MEB, Collier D, Law K, Liao K, Michaud K, Morgan-DeWitt E, Oates J, Orozco C, Reimold A, Simard JF, Kazi S. A National Electronic Health Record-Enabled Registry in Rheumatology: The ACR’s Rheumatology Informatics System for Effectiveness (RISE) [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/a-national-electronic-health-record-enabled-registry-in-rheumatology-the-acrs-rheumatology-informatics-system-for-effectiveness-rise/. Accessed .

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