Registries

Is a Patient registry the answer to dissuade a practice from implementing EHR?

What is a registry? A registry in the health care domain is as a file containing uniform information about individual persons, collected in a systematic and comprehensive way, in order to serve a predetermined purpose. Registries can be administrative registries, registries for clinical trials, registry for longitudinal observational studies (Patient registries) and registries for genetic studies. What is a Patient registry? “A patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves a predetermined scientific, clinical, or policy purpose(s). The registry database is the file (or files) derived from the registry.”1

EHR adoption and Patient registries: A study by the Harvard school of public health in 2009 in a press release 2 found that though there is broad consensus that electronic health records (EHR) have the potential to improve the efficiency and effectiveness of healthcare providers , the adoption rate of EHR’s has been extremely slow. The main reason for this slow adoption is mainly economic, in hospitals and small practices. Dr.Ortiz, a family physician contends that a practice does not need an EHR to improve care but instead all practices can use existing patient registries to achieve the same improvement in health care delivered. In his, article 3 termed “Who needs an EHR? Software you already have can help you make sure your patients get the care they need.” – He describes in detail how to use simple computer tools such as excel or Microsoft access to manage chronic diseases. The specific example in Dr.Ortiz’s article is a patient registry for type 2 diabetes. This approach will be a front load in terms of time invested in entering all the details into a spreadsheet. However, would this be a better ROI than an expensive EHR system? Training staff to data mine from a spread sheet would be a lot easier than training someone on a complex EHR system would it not? Should small practice physicians try this out before investing in EHR systems despite the federal incentive carrots that are dangling? I am just playing the devil’s advocate here. By presenting this article here, I would like to get the view of other informaticians. I honestly had never thought of this till I by chance came across this article - so what do others thing?

References: 1 Gliklich RE, Dreyer NA, eds. Registries for Evaluating Patient Outcomes: A User’s Guide. (Prepared by Outcome DEcIDE Center [Outcome Sciences, Inc. dba Outcome] under Contract No. HHSA29020050035I TO1.) AHRQ Publication No. 07-EHC001-1. Rockville, MD: Agency for Healthcare Research and Quality.April 2007.

2 Press release from Harvard school of public health on March 25th 2009, Available from: http://www.hsph.harvard.edu/news/press-releases/2009-releases/us-hospitals-extremely-slow-to-adopt-electronic-health-records.html

3 Ortiz DD, Fam Pract Manag. 2006 Apr;13(4):47-8, 51-2.”Using a simple patient registry to improve your chronic disease care”, Available from: http://www.aafp.org/fpm/2006/0400/p47.html

Submitted By : Latha Kalaga