Photo Credit: Aleksei Naumov
Participation of medical centers in the RISE registry was associated with rapid improvements in performance across several quality measures of rheumatology care. Improvements were most marked for rheumatoid arthritis (RA) process measures. These results underscore that registry participation can potentially enhance the quality of care.
The ACR’s Rheumatology Informatics System for Effectiveness (RISE) started in 2014 and passively collects data directly from the Electronic Health Records (EHR) system. An Interrupted Times Series (ITS) analysis before and after the participation of professional medical centers explored if it is associated with improving quality of care1. The results were presented by Dr. Gabriela Schmajuk, MD, MsC, from the University of California, in San Francisco.
The study included 85 medical centers that joined RISE between 2015 and 2020. Dr. Schmajuk explained that performance on six rheumatology-specific quality measures was evaluated. These included RA functional status assessment, RA periodic disease activity assessment, tuberculosis screening, and osteoporosis screening, all introduced in 2017; and two ‘control’ measures introduced in 2020: hepatitis B safety screening and RA low disease activity or remission. The primary outcome was quality measure performance in 30 overlapping cross-sections, for the six different measures.
The 85 medical centers cared for 331,975 unique patients, 88% were women, with a mean age of 71 years. Performance on all six measures improved after medical centers joined RISE but to varying degrees. “The change in the 2 RA process measures was pretty dramatic,” observed Dr. Schmajuk. For RA periodic disease activity assessment, the increase in performance per month was 0.8 percentage points (increasing from 0.4 to 1.2), which was statistically significant (P<0.05). For the RA functional status assessment, the increase was 0.6 percentage points (from 0.6 to 1.2). The other four measures did not show meaningful differences in the rate of change. Performance typically improved within the first month and continued an upward trajectory. Medical centers whose baseline performance was below the median improved more rapidly.
Medical writing support was provided by Michiel Tent
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