Blumenthal Seth
PCPI Foundation.
EGEMS (Wash DC). 2017 Dec 7;5(1):26. doi: 10.5334/egems.248.
The use of information from clinical registries for improvement and value-based payment is increasing, yet information about registry use is not widely available. We conducted a landscape survey to understand registry uses, focus areas and challenges. The survey addressed the structure and organization of registry programs, as well as their purpose and scope.
The survey was conducted by the National Quality Registry Network (NQRN), a community of organizations interested in registries. NQRN is a program of the PCPI, a national convener of medical specialty and professional societies and associations, which constitute a majority of registry stewards in the United States.
We surveyed 152 societies and associations, asking about registry programs, governance, number of registries, purpose and data uses, data collection, expenses, funding and interoperability.
The response rate was 52 percent. Many registries were self-funded, with 39 percent spending less than $1 million per year, and 32 percent spending $1-9.9 million. The typical registry had three full-time equivalent staff. Registries were frequently used for quality improvement, benchmarking and clinical decision support. 85 percent captured outpatient data. Most registries collected demographics, treatments, practitioner information and comorbidities; 53 percent captured patient-reported outcomes. 88 percent used manual data entry and 18 percent linked to external secondary data sources. Cost, interoperability and vendor management were barriers to continued registry development.
Registries captured data across a broad scope, audited data quality using multiple techniques, and used a mix of automated and manual data capture methods. Registry interoperability was still a challenge, even among registries using nationally accepted data standards.
临床登记处信息用于改进和基于价值的支付的情况日益增多,但关于登记处使用的信息却并不广泛可得。我们开展了一项全景调查,以了解登记处的用途、重点领域和挑战。该调查涉及登记处项目的结构和组织,以及其目的和范围。
该调查由国家质量登记网络(NQRN)开展,NQRN是一个对登记处感兴趣的组织群体。NQRN是PCPI的一个项目,PCPI是医学专业及专业协会和社团的全国召集机构,这些机构构成了美国大多数登记处的管理机构。
我们对152个社团和协会进行了调查,询问了登记处项目、治理、登记处数量、目的和数据用途、数据收集、费用、资金和互操作性等问题。
回复率为52%。许多登记处是自筹资金,39%的登记处每年支出少于100万美元,32%的登记处支出为100万至990万美元。典型的登记处有三名全职等效员工。登记处经常用于质量改进、基准对比和临床决策支持。85%的登记处获取门诊数据。大多数登记处收集人口统计学信息、治疗信息、从业者信息和合并症信息;53%的登记处获取患者报告的结果。88%的登记处使用手动数据录入,18%的登记处与外部二级数据源相链接。成本、互操作性和供应商管理是登记处持续发展的障碍。
登记处广泛收集数据,使用多种技术审核数据质量,并采用自动和手动数据采集方法相结合的方式。即使在使用全国公认数据标准的登记处之间,登记处的互操作性仍然是一个挑战。