Registry participation can enhance quality of rheumatology care

Participation of medical centres 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 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. All patients in a medical centre are automatically included. RISE facilitates quality measure reporting to national pay-for-performance programmes. Dr Gabriela Schmajuk (University of California, San Francisco, CA, USA) and colleagues performed an Interrupted Times Series (ITS) analysis before and after the participation of a professional medical centre to see if it was associated with improved quality-of-care [1].

The study included 85 medical centres that joined RISE between 2015 and 2020 and had sufficient data to complete the ITS analysis. Performance on 6 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, as well as 2 ‘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 6 different measures.

The 85 medical centres cared for 331,975 unique patients, of which 88% were women and with a mean age of 71 years; 52 (61%) medical centres were single-specialty. Performance on all 6 measures improved after medical centres 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 monthly performance was 0.8 percentage points (increasing from 0.4 to 1.2), which was statistically significant (P<0.05). The increase for RA functional status assessment was 0.6 percentage points (from 0.6 to 1.2). The other 4 measures did not show meaningful differences in the rate of change. Performance typically improved within the first month and continued on an upward trajectory. Medical centres whose baseline performance was below the median improved more rapidly.

1. Schmajuk G, et al. RISE Registry associated with significant gains in quality measure performance: an interrupted times series analysis before and after participation. Abstract 1644, ACR Convergence 2024, 14–19 November, Washington DC, USA.

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Posted on 13 January 202514 January 2025