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Usefulness of the Chronic Disease Registries

Registry improvements better track progresses meeting performance indicators.

Chronic Disease registries are now more widely used for government and insurance plans to allocate resources and reward or penalize hospitals and providers based on outcomes. These registries can also influence patients’ choices when it comes to where they want to get their care.

Alan Sacerdote and colleagues examined the validity of the registries by looking into the New York City Health and Hospitals Corporation Diabetes Registry (NYCHHCDR), which included more than 63,000 patients. The registry should have data tracking progress to meet “performance indicators” (PI’s) for improvements over time; however, it only provides a “snapshot” of all registry patients in an institution at a given time.

Targets for different chronic diseases are tracked at PI’s and are being documented 2 to 4 times per year. Providers can document recommendations to help patients meet targets, but patients sometimes follow these recommendations inconsistently. Some of the reasons can be:

  •       nonadherence
  •       they cannot read or comprehend the labels on their pill bottles
  •       they put all their medications in one bottle
  •       their prescriptions remain unfilled.

There are several factors that can also influence the registry’ scores, whether it is due to lack of consistency in how to use or input information in the registry, auditors not being adequately trained, or whether the patients never return during the reviewed quarter. There can also be inappropriate PI’s for many patients because there is no one-size-fits-all when it comes to developing and monitoring desired targets for different individuals.

Recently, the registry has acknowledged its shortcomings and developed ways to improve by building an ancillary website. These new changes involved:

  • having a stable cohort of patients within each provider’s/facility’s panel so that the interventions can be evaluated for efficacy
  • provider PI’s must only indicate provider performance
  • PI’s that are evidence-based and is appropriate for the patient’s demographic
  • having adequately trained auditors.

Practice Pearls:

  • Institution’s registries can influence the resources that it might receive from the government or insurance company and also on patients’ preferences.
  • Performance indicators are tracked as meeting certain targets for the different chronic diseases and are being documented 2 to 4 times per year.
  • Chronic Disease Registries are being improved upon to better track progresses meeting performance indicators.

Sacerdote A, Inoue T, Liaqat S, and Flores J. Improving the Usefulness of Chronic Disease Registries as a Tool to Improve Patient Outcomes; Observations on Several Years’ Experience with the New York City Health & Hospital Corporation’s Diabetes Registry. Web. 07 Oct 2015.