TY  - JOUR
AU  - Hammam, Nevin
AU  - Izadi, Zara
AU  - Li, Jing
AU  - Evans, Michael
AU  - Kay, Julia
AU  - Shiboski, Stephen
AU  - Schmajuk, Gabriela
AU  - Yazdany, Jinoos
PY  - 2021
DA  - 2021/11/12
TI  - The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational Study
JO  - JMIR Med Inform
SP  - e31186
VL  - 9
IS  - 11
KW  - rheumatoid arthritis
KW  - electronic health record
KW  - patient-reported outcomes
KW  - quality measures
KW  - disease activity
KW  - quality of care
KW  - performance reporting
KW  - medical informatics
KW  - clinical informatics
AB  - Background: Routine collection of disease activity (DA) and patient-reported outcomes (PROs) in rheumatoid arthritis (RA) are nationally endorsed quality measures and critical components of a treat-to-target approach. However, little is known about the role electronic health record (EHR) systems play in facilitating performance on these measures. Objective: Using the American College Rheumatology’s (ACR’s) RISE registry, we analyzed the relationship between EHR system and performance on DA and functional status (FS) quality measures. Methods: We analyzed data collected in 2018 from practices enrolled in RISE. We assessed practice-level performance on quality measures that require DA and FS documentation. Multivariable linear regression and zero-inflated negative binomial models were used to examine the independent effect of EHR system on practice-level quality measure performance, adjusting for practice characteristics and patient case-mix. Results: In total, 220 included practices cared for 314,793 patients with RA. NextGen was the most commonly used EHR system (34.1%). We found wide variation in performance on DA and FS quality measures by EHR system (median 30.1, IQR 0-74.8, and median 9.0, IQR 0-74.2), respectively). Even after adjustment, NextGen practices performed significantly better than Allscripts on the DA measure (51.4% vs 5.0%; P<.05) and significantly better than eClinicalWorks and eMDs on the FS measure (49.3% vs 29.0% and 10.9%; P<.05). Conclusions: Performance on national RA quality measures was associated with the EHR system, even after adjusting for practice and patient characteristics. These findings suggest that future efforts to improve quality of care in RA should focus not only on provider performance reporting but also on developing and implementing rheumatology-specific standards across EHRs. 
SN  - 2291-9694
UR  - https://medinform.jmir.org/2021/11/e31186
UR  - https://doi.org/10.2196/31186
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34766910
DO  - 10.2196/31186
ID  - info:doi/10.2196/31186
ER  -