Registry Can Fill EHR Reporting Void

Thursday, January 14th, 2010
This post was written by Melanie Matthews

Advice from a multi-payor medical home pilot: get a patient registry and start using it. It’s the single tool that can help transform practices into a medical home, promote quality improvement and deliver evidence-based care, recommends Julie Schilz, IPIP and PCMH manager for the Colorado Clinical Guidelines Collaborative in a new podcast — even more effectively than current electronic medical records on the market.

Registries are collections of secondary data related to patients with a specific diagnosis, condition, or procedure. Registries range in simplicity from a collection of paper cards maintained by an individual physician to simple spreadsheets accessible by a small group of physicians to complex databases accessed online across multiple organizations.

Many of the physician practices in Colorado’s year-old medical home pilot already have EMRs but are still doing double data entry into registries in order to generate the reports they need to improve care management and delivery, says Schilz, who will provide an update on the Colorado Multi-Payor Medical Home Pilot in an upcoming webinar. The registry allows practices to better understand its population, perform outreach to patients, verify that it is practicing in conjunction with evidence-based guidelines and generate valuable reports that let them know how they’re doing, Schilz notes.

The lack of a reporting feature is a common complaint among physicians using EMRs as well as a significant barrier to meeting CMS’s proposed objectives for meaningful use of EMRs, finds a new report from KLAS Research. The report found that physicians with ambulatory EMR software say EMRs lack a number of functional areas, including reporting tools, patient access to medical records and the ability to share key clinical data. More than 17 percent of providers say reporting is difficult or impossible with their current tools, and another 24 percent report needing specific technical expertise to manipulate the tools provided, said Mark Wagner, KLAS director of ambulatory research and author of the new report.

Here’s an example of how a registry can improve care for chronic conditions. Two years ago, Apple Valley Medical Center, one of six clinics participating in Medica’s clinic-based chronic care management program, developed a registry of its patients with diabetes to allow the clinic to track them better. The registry provides staff with daily reminders on patient status so that any issues are addressed promptly. Based on the issue, the provider involved may be a nurse, nurse practitioner, physician or other provider. As a result of this approach, Apple Valley Medical Center was able to improve its community standing on this measure by 110 percent in the first year of the program. Its patients with diabetes “at goal” for optimal diabetes care, as reported to Minnesota Community Measurement, moved up 23 percentage points in one year.

According to a new national study by the Center for Studying Health System Change, only four in 10 of primary care physicians whose practices care for patients with four common chronic conditions—asthma, diabetes, congestive heart failure and depression—were in practices using registries to keep track of patients with chronic conditions.

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