RA quality measures improve among practices participating in ACR's RISE registry
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Practices that participated in the American College of Rheumatology’s RISE registry between 2015 and 2017 enjoyed improved performance in rheumatoid arthritis quality measures, according to findings published in Arthritis Care & Research.
“Rheumatology Informatics System for Effectiveness (RISE) is an electronic health record (EHR)-enabled registry developed by the American College of Rheumatology to facilitate quality improvement among rheumatology practices nationally,” Zara Izadi, PharmD, MAS, of the University of California, San Francisco, and colleagues wrote. “RISE passively extracts EHR data from individual practices, aggregates and analyzes these data centrally, and feeds this information back to clinicians as actionable data using a web-based quality dashboard.”
“By providing robust health IT infrastructure, the registry aims to decrease the burden of data collection on practices and streamline participation in federal quality reporting programs such as the Merit-based Incentive Payment System (MIPS),” they added. “An additional benefit of the dashboard is to facilitate local rapid-cycle quality improvement by providing continuous performance feedback and benchmarking.”
To examine RA quality-measure performance, as well as the link between practice characteristics and performance changes over time, among practices participating in RISE, Izadi and colleagues analyzed registry data from Jan. 1, 2015, to Dec. 31, 2017. In all, data from 59,986 patients from 54 practices were included. Most of these patients — 46% — were seen in a single-specialty group practice.
The researchers examined eight quality measures in RA disease management, cardiovascular risk reduction and patient safety. Performance variability was assessed at the practice level, and multivariate linear models were used to predict changes in performance by year. They were also used to determine the impact of practice characteristics on performance change over time.
According to the researchers, the average performance on RA-treatment measures was consistently high — at more than 90%. Measures related to RA functional status and disease activity assessment demonstrated the greatest improvements over time, with 8.4% and 13% increases per year, respectively (P < .001). Singlespecialty group practices enjoyed the fastest rates of improvement over time across all measures.
“This paper provides a systematic benchmarking of the ACR quality measures using data from 54 practices participating in the RISE registry,” Izadi and colleagues wrote. “Results from this study indicate excellent performance on DMARD prescribing and steady improvements in documentation of disease activity and functional status over a three-year period between 2015 to 2017.”
“Blood pressure control and TB screening measures may deserve the most attention in performance improvement initiatives, although notable improvements on these measures were observed among some practices,” they added. “Identification of workflow patterns leading to high performance or dramatic improvements in quality of care will help guide strategies to address gaps in priority areas.”
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