advantages of a patient registry in the primary care setting

Certainly the federal government’s effort to dramatically change healthcare here in the United States is a hot topic. I have seen many articles online in healthcare blogs, financial sites such as the Wall Street Journal’s and Modern Healthcare’s, and in printed media, such as Time magazine. There are many points of view but all seem to focus on controlling costs while improving access. In my opinion, one key to success is improving access to primary care while focusing more on prevention and management of chronic diseases in this setting.
Making the changes in the primary care setting will be difficult, to say the least. One tool that can help a lot is the patient registry, an IT tool that is much like a “to do calendar.” Registries range in features from one or two functions to multifunction. A simple one can be created by an individual using Microsoft Excel; you can find out how to do this in the April 2006 “Family Practice Management.”
WellCentive is one company which offers multifunctional registries. No matter the complexity, though, the intent is to remind physicians about needed care for their current patients. For instance, a registry could remind a practice that patient X with type 2 diabetes is due for an a1c test within two weeks. Then a staff member can contact the patient if the patient has not already made an appointment and make arrangements for the test and other blood work before coming in to the office. This tool greatly expands the reach of the physician in prevention and management of chronic diseases as it helps get those patients who might otherwise neglect making appointments in to the office at the right time. Without this tool it was next to impossible for physicians to keep track of these forgetful patients.
A simple registry as detailed in the April 2006 issue of “Family Practice Management (which you can find online for free, by the way) has only a few features, such as the patient name, contact information for the patient, the upcoming needed care and when it is due, if not past due. WellCentive’s online registry has all these features and much more. For instance:
? Direct reporting to payers for pay-for performance
? Collects both administrative and clinical data
? CMS PQRI certified data collection and reporting
? Point of care decision support
? Patient portal
? Population management tools
Physicians who use online services such as this find that they pay for themselves while improving patient outcomes and income.
There is much support for registries from a variety of sources. For example, the National Committee for Quality Assurance (NCQA) in its accreditation program for the patient-center medical home supports the use of registries for many of its standards. For example,
? A system for managing patient data, such as preferred method of communication
? Guidelines for evidence-based treatment
? Lab reports and test results
The Patient Centered Primary Care Collaborative (PCPPC) also supports registries. Jim Clifford, a contact of mine at WellCentive (WellCentive is on the executive board of PCPPC), stated that at the March Medical Home Summit in Philadelphia, many physicians spoke in support of adopting registries instead of or in addition to Electronic Medical Records (EMR’s). I find this amazing, given that the federal government will be providing a substantial monetary incentive to practices adopting EMR’s. It may be that when HHS adopts its final rules for certifying which electronic systems qualify for the health stimulus that registries may be included.