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Unlike most EHRs, registries can make patient data accessible and actionable, leading to better outcomes and easier quality reporting.

Fam Pract Manag. 2021;28(6):21-24

This content conforms to AAFP criteria for CME.

Author disclosures: no relevant financial affiliations.

Medical practices collect large amounts of data in their electronic health records (EHRs), but using that data to make informed decisions can be challenging. Historically, EHRs have proven to be ill-suited for population health management, quality improvement, performance reporting, and care management. Registries can make electronic data more accessible and actionable.

WHAT IS A REGISTRY?

A registry is a population health tool that excels at organizing data for a group of patients and providing timely, actionable reports that can be used for care management and quality improvement. The registry obtains data from EHRs, other electronic data sources, or manual data entry. It then organizes and analyzes the data and presents it in dashboards and reports for easy interpretation. Information can be used to make clinical and administrative decisions, such as reaching out to patients to close care gaps or proactively identifying at-risk patients who may need more intense care so the staff can develop intervention strategies.

A registry may be used primarily at the practice level for patient care, or it may be a national or regional database registry.1

A patient care registry is used at the point of care to inform treatment decisions, highlight gaps in care, and manage care of high-risk or high-need patients. It is maintained as part of the practice's daily work-flow and updated in real time.

A national or regional database registry is used for population management, setting benchmarks, comparing performance among participants, value-based payment, risk stratification, strategic planning, contract negotiation, quality improvement, and reporting. Reports are generated at regular intervals, such as monthly, and fed back to the practice. These types of registries are not generally designed to be used at the point of care due to the data lag.

A registry may include the entire patient panel or only a subset of patients who share a common chronic disease or condition, such as diabetes, coronary artery disease, or asthma. The population included is determined by how the practice intends to use the registry. For example, if the practice will use the registry to report Merit-Based Incentive Payment System (MIPS) data, then all patients should be included. If the practice will use the registry only for diabetes management, then only patients with diabetes should be included, or the registry should be able to segment patients with diabetes from all patients.

Registries are normally maintained electronically for optimal efficiency and use. A simple electronic spreadsheet is the most basic form of registry and may be used in a small practice to manage a small group of patients with a specific disease, such as tracking A1C levels for patients with diabetes. Many EHR vendors offer more sophisticated registries as add-ons for their systems. These types of registries are useful at the point of care because their data is accessible and updated in real time as part of the routine office workflow. Third parties also offer registries that extract data from digital sources, such as EHRs and administrative claims. These tend to be regional or national database registries.

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