3 Ways to Use Registries to Close Care Gaps

Tuesday, September 3rd, 2013
This post was written by Jessica Fornarotto

There are many benefits to registries, including identifying groups of patients who require certain tests, as well as those who are at high-risk, says Dr. Gregory Spencer, chief medical officer of Crystal Run Healthcare. Dr. Spencer also explained how registries are useful for identifying gaps in patient care in three areas: health maintenance, disease management and quality measures.

Health maintenance looks at who is due for what and when, based on a subset of people that you are looking at. The lines blur as to why this registry is different than just saying it’s everybody over 50; it’s the same thing. That is part of the demystification of registries; you are doing this already in the areas of health maintenance, quality measures and then disease management (DM). The two registries that we often use are for patients with diabetes — first, those that are poorly controlled, and second, patients on Coumadin®, because they are very high risk for serious health events.

In using the registries in our practice, we have 12 clinical divisions. Each one is headed by a physician from that specialty. Quality efforts and information is dealt with on the front line there. We have a quality committee that works with the divisions to develop these registries and then implement them for quality efforts. We then have a higher practice-level committee for quality and patient safety. In addition to clinical people, there are also facilities people and the billing office, to name a few. This way, we have a more broad-based view of these data.

We try to collect necessary data only once and not have people re-enter things. Use data over and over and over. If you gathered it and spent the effort, you might as well try to use it for many purposes.

For our quality measures, we collect what we can easily measure and there are repeated themes. We involve the IT team early and often. The more specific you can be, the better; they will want detailed specifications. But at the same time, if you spend a lot of time thinking about something and it turns out to be completely undoable, you wasted some of your time, too. Having a good relationship with somebody who can work with you on the back end is important because they help shape that.

Also, know where the data is kept and entered. This requires somebody that knows your system, hopefully somebody in-house who has gotten to know it, perhaps a vendor. It has been very useful for us to have somebody who can work as a clinician. In our practice, that is me. I am also the chief medical information officer, so I meet with the IT experts all the time. I am able to act as an information broker. I can rephrase questions if there is confusion, and then also assure that the data coming out is appropriate. You need somebody that can talk the talk and make sure that the right information is being delivered and gathered.

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