Background In 2014, the ACR launched the Rheumatology Informatics System for Effectiveness (RISE), a national electronic health record (EHR)-enabled registry. RISE passively collects data from EHRs of participating practices, provides advanced quality measurement and data analytic capacities, and can be used to fulfill national quality reporting requirements. Here we detail the characteristics of practices participating in RISE, patient characteristics and performance on several nationally endorsed quality measures.
Methods RISE is a national Qualified Clinical Data Registry (QCDR), allowing collection of data on quality of care without individual patient informed consent. Participating practices enter a Data Use Agreement with the ACR, after which local data are mapped, validated and uploaded regularly to the central registry. Practices can access an analytics dashboard that allows review of up-to-date information on quality measures by provider and practice as well as national benchmarks. RISE currently includes data on numerous quality measures regarding rheumatoid arthritis (RA), drug safety, osteoporosis prevention and treatment, low back pain, and preventive health care (e.g. smoking, blood pressure management). We analyzed data between October 1, 2014 and September 30, 2015 to characterize practices and patients captured in RISE. We also calculated performance on several RA quality measures endorsed by the National Quality Forum (DMARD use, disease activity measurement, functional status measurement).
Results During the dates examined, RISE included data on 239,302 patients, including 60,354 with RA (Table). Three hundred twelve clinicians across 55 sites contributed data to RISE. Characteristics of patients in RISE are summarized in the Table. For the subset of patients with RA, 50.7% of patients had a disease activity score recorded, 53.2% had a functional status score recorded, and 82.1% were taking a DMARD, as defined by national quality measures. For DMARDs, 34.4% of patients with RA were on brand name biologic or small molecule drug at their last encounter, and 67.0% were receiving a non-biologic DMARD.
Conclusions The ACR's national EHR-enabled registry will provide critical infrastructure for improving quality of care in rheumatology and will serve as a unique data source to generate new knowledge regarding rheumatic disease. Data validation and mapping is ongoing and RISE will be available to both the research and clinical community to use to advance rheumatology.
Disclosure of Interest None declared