Background: 

The RCR was launched by the ACR to provide members with an infrastructure for quality reporting related to rheumatoid arthritis, gout, osteoarthritis, osteoporosis, and drug safety. The RCR is now in its third year of operation with data on over 26,000 patients.  Here we report the uptake of the RCR by U.S. rheumatologists, and performance on measures regarding functional status, DMARD use, TB screening, prognosis, and disease activity assessment for RA patients in rheumatology practice.

Methods:   

Data derive from retrospective medical records abstractions performed by providers and designated practice staff for a sample of patients seen by the rheumatologist. Reporters submit data on quality measures via a secure, web-based registry system.  Patients included in the denominator of all quality measures are >18 years of age with a diagnosis of RA who are receiving treatment by the reporting rheumatology provider. Additional details of each measure are listed in Table 1.  We report the mean performance on each quality measure, defined as percentage of eligible patients receiving recommended care.

Results: 

257 rheumatology providers in 143 practices submitted data on 8096 patients with RA from January 1, 2011 to December 31, 2011. Reporting providers practice in sites ranging from solo offices to large academic centers.

 

Table 1. Performance on RA Measures Assessed through the RCR (01/11-12/11)
	Total eligible patients (n)	Performance on Quality Measure (%)
Functional status assessment performed at least once within 12 months, and documented using a standardized descriptive or numeric scale, or notation of assessment of the impact on patient activities of daily living	8077	70.5%
Patient prescribed, dispensed, or administered at least one ambulatory prescription for a DMARD within 12 months	7808	97.9%
Documentation of TB screening performed and results interpreted within 6 months prior to receiving first course DMARD	1650	73.6%
Assessment and classification of disease prognosis at least once within 12 months	7771	49.5%
Disease activity assessed and classified at least once within 12 months, using a standardized descriptive or numeric scale or composite index	8075	43.3%

Conclusions: 

• Rheumatologists across the country used the RCR in 2011 to report quality data establishing RCR as a mechanism for quality reporting (consistent with the ACR goal that RCR provide maximal benefit from data submission).
• Next steps planned for the ACR registry efforts include the continual enhancement of the quality of data collected, analytic reports promoting key performance indicators, and EHR-enabled reporting and quality improvement analysis through a federated registry network.

• RCR provides an opportunity for rheumatology providers to facilitate practice improvement, contribute to collaborative improvement projects, and contribute to national data, led by their professional society.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/uptake-of-the-american-college-of-rheumatologys-acr-rheumatology-clinical-registry-rcr-quality-measure-summary-data/