title: Clinical Case Registries: simultaneous local and national disease registries for population quality management.
abstract: The Department of Veterans Affairs (VA) has a system-wide, patient-centric electronic medical record system (EMR) within which the authors developed the Clinical Case Registries (CCR) to support population-centric delivery and evaluation of VA medical care. To date, the authors have applied the CCR to populations with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). Local components use diagnosis codes and laboratory test results to identify patients who may have HIV or HCV and support queries on local care delivery with customizable reports. For each patient in a local registry, key EMR data are transferred via HL7 messaging to a single national registry. From 128 local registry systems, over 60,000 and 320,000 veterans in VA care have been identified as having HIV and HCV, respectively, and entered in the national database. Local and national reports covering demographics, resource usage, quality of care metrics and medication safety issues have been generated.
authors.affiliation: Center for Quality Management in Public Health, Palo Alto HCS, 3801 Miranda Avenue 132, Palo Alto, CA 94304, USA. lisa.backus@va.gov
authors.forename: Lisa I
authors.initials: LI
authors.lastname: Backus
authors.forename: Sergey
authors.initials: S
authors.lastname: Gavrilov
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Loomis
authors.forename: James P
authors.initials: JP
authors.lastname: Halloran
authors.forename: Barbara R
authors.initials: BR
authors.lastname: Phillips
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Belperio
authors.forename: Larry A
authors.initials: LA
authors.lastname: Mole
mesh_terms: D020000:Decision Support Systems, Clinical; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D009096:Multi-Institutional Systems; D011785:Quality Assurance, Health Care; D012042:Registries; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000706:statistics & numerical data