Patient Registry Software, Disease Registry, Clinical Registry Software

10 "Must Haves" in a CQMS

#1: An all-patient, all-problem registry of clinically-validated information not dependent on billing optimization.

Throughout the country, clinics and practices are tackling the problem of quality improvement-not only to meet new pay-for-performance standards, but also to provide a higher level of care. Many providers are finding that a well-chosen CQMS supports their efforts and greatly improves their success. This ongoing series will highlight ten essential features for any clinical quality improvement system.

The Must Haves

An all-problem, all-patient registry of clinically-verified information not dependent on billing optimization
Problems documented in a structured and coded manner, using clinical terminology
A sophisticated rules engine of clinical care guidelines that thinks like a physician, not like a computer system
Point-of-care functionality to provide easy identification of due items and increase visit efficiency
Tools to reach patients due for services but not scheduled for a visit
On-demand reporting providing actionable data for quality improvement
Features to allow the entire care team to focus on quality
Extensibility to other HIT systems to share relevant clinical information
Vendor-supported, secure and scalable technology
A customizable framework to meet the unique needs of a practice

Often, the only data available for documenting a patient's problems is administrative data, the data used for billing. This information was never intended to be a source of clinical information on a patient and, as such, does not provide the necessary picture of information when delivering care. The difficulty of culling usable knowledge from this source of incomplete and unrepresentative information is frustrating for practices trying to meet quality benchmarks and improve their level of care.

Seeing a complete picture of a patient population.

A clinical quality management system uses a registry to capture patient information. An effective registry must track the entire patient population of a practice and the entire set of problems associated with each patient. It also must track problems in a manner unbiased by the needs of administrative data and verifiable by a clinician. With an all-patient, all-problem registry of clinically-verified information, a practice benefits in many ways:

Allows providers to manage all of their patients, and manage them based on multi-morbidity issues. For example, patients with both diabetes and depression can have different treatment recommendations than those with just diabetes.

Ensures care decisions are based on an accurate, documented set of problems.

Helps practices meet the needs of existing pay-for-performance programs and provides a solid foundation for meeting future quality initiatives yet to be defined.

Correctly identifies patient populations, ensuring quality calculations are based on the correct denominator of a population measure to avoid negative financial implications.

Improves the delivery of care by allowing providers to track patient episodes of care, supplying a complete picture of a condition as is progresses over time.

Makes the CQMS an integral part of every patient visit, ensuring the system becomes part of a practice's standard workflow.

An effective registry must track the entire patient population of a practice and the entire set of problems associated with each patient in a manner unbiased by the needs of administrative data and verifiable by a clinician.

Choosing an effective registry.

Make certain that the registry only uses clinically-verified information. Using administrative data that is not reviewed by a clinician can lead to incorrect care and waste a provider's time.

Finally, providers should consider how use of the registry will incorporate into their daily operations. A well-designed CQMS will be developed with clinical workflow in mind and should integrate transparently into a practice's routine activities.

Choosing the right system for quality improvement is crucial to any 21st century medical practice. The registry is a key component of any strong clinical quality management system and should be evaluated against the highest of standards.

Next issue: Problems documented in a structured and coded manner, using clinical terminology

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