EHR No Substitute for Population View Provided by Registries

Tuesday, January 31st, 2012
This post was written by Patricia Donovan

The proliferation of EHRs is driving the format and functionality of patient registries today, according to new market research from the Healthcare Intelligence Network.

However, healthcare experts note that EHRs are no substitute for a registry.

“Registry functionality is not always the same as an EMR,” cautions Julie Schilz, manager, IPIP and PCMH for the Colorado Clinical Guidelines Collaborative. “Registry functionality is the ability to understand your patient population and their needs, whether they are being managed against evidence-based guidelines, being able to support outreach to patients who might be falling outside of the guidelines and understand per provider how their patients are being managed against evidence-based guidelines.”

The registry is used in a positive way for quality improvement, Schilz notes, not as a stick to suggest that providers and their care team are not managing effectively.

“The registry is utilized to help manage the patient population and understand how, in using the measures as a proxy, the systems that the practices put into place are having the desired impact on patient population for both health and healthcare delivery,” she concludes.

While more than two thirds of 2008 survey respondents favored freestanding database-centered registries, the trend in 2012 is toward registries as a component of an EHR, as reported by one-third of 2011 respondents, or Web-based registries, used by another 29 percent of this year’s respondents.

Registry use has remained constant at about 50 percent since HIN last surveyed the healthcare industry on this topic in 2008.

This year’s analysis also found that registries are used more than three times as often today to generate health alerts and reminders for appointments and preventive services. Only a quarter of 2008 respondents were using registries in this proactive manner. Whether as simple as an Excel® spreadsheet or a module in an EHR, healthcare organizations have warmed to the patient-tracking features and the population-eye view that registries deliver.

“To move primary care forward, you want the care team to begin preparation for visits well in advance of the patient arriving,” adds Michael Erikson, vice president of primary care services for Group Health Cooperative, an organization touted by CMS for its advanced and comprehensive primary care services. “With our EMR, which has registry-like functions within it, we know the care gaps of the patients who are coming for a visit; we see all their HEDIS measures. The team begins, one to three days before visits occur, to look for any of those care gaps, so that when a patient arrives for a visit, not only are we responding to their acute need, but we are also responding comprehensively to address any care gaps, whether that be a chronic illness, a preventive need or an acute need.”

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