title: Rheumatology Informatics System for Effectiveness: A National Informatics-Enabled Registry for Quality Improvement.
abstract: The Rheumatology Informatics System for Effectiveness (RISE) is a national electronic health record (EHR)-enabled registry. RISE passively collects data from EHRs of participating practices, provides advanced quality measurement and data analytic capacities, and fulfills national quality reporting requirements. Here we report the registry's architecture and initial data, and we demonstrate how RISE is being used to improve the quality of care.
  
  
  
  RISE is a certified Centers for Medicare and Medicaid Services Qualified Clinical Data Registry, allowing collection of data without individual patient informed consent. We analyzed data between October 1, 2014 and September 30, 2015 to characterize initial practices and patients captured in RISE. We also analyzed medication use among rheumatoid arthritis (RA) patients and performance on several quality measures.
  
  
  
  Across 55 sites, 312 clinicians contributed data to RISE; 72% were in group practice, 21% in solo practice, and 7% were part of a larger health system. Sites contributed data on 239,302 individuals. Among the subset with RA, 34.4% of patients were taking a biologic or targeted synthetic disease-modifying antirheumatic drug (DMARD) at their last encounter, and 66.7% were receiving a nonbiologic DMARD. Examples of quality measures include that 55.2% had a disease activity score recorded, 53.6% a functional status score, and 91.0% were taking a DMARD in the last year.
  
  
  
  RISE provides critical infrastructure for improving the quality of care in rheumatology and is a unique data source to generate new knowledge. Data validation and mapping are ongoing and RISE is available to the research and clinical communities to advance rheumatology.
authors.affiliation: University of California, San Francisco.
authors.forename: Jinoos
authors.initials: J
authors.lastname: Yazdany
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Nick
authors.initials: N
authors.lastname: Bansback
authors.affiliation: Duke University, Durham, North Carolina.
authors.forename: Megan
authors.initials: M
authors.lastname: Clowse
authors.affiliation: Massachusetts General Hospital, Boston.
authors.forename: Deborah
authors.initials: D
authors.lastname: Collier
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Karen
authors.initials: K
authors.lastname: Law
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Katherine P
authors.initials: KP
authors.lastname: Liao
authors.affiliation: University of Nebraska Medical Center, Omaha, and the National Data Bank for Rheumatic Diseases, Wichita, Kansas.
authors.forename: Kaleb
authors.identifier: 0000-0002-5350-3934
authors.initials: K
authors.lastname: Michaud
authors.affiliation: James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Esi M
authors.initials: EM
authors.lastname: Morgan
authors.affiliation: Medical University of South Carolina, Charleston.
authors.forename: James C
authors.initials: JC
authors.lastname: Oates
authors.affiliation: Rheumatology Associates, Dallas, Texas.
authors.forename: Catalina
authors.initials: C
authors.lastname: Orozco
authors.affiliation: Dallas Veterans Affairs Medical Center and University of Texas Southwestern Medical Center, Dallas.
authors.forename: Andreas
authors.initials: A
authors.lastname: Reimold
authors.affiliation: Stanford School of Medicine, Stanford, California.
authors.forename: Julia F
authors.initials: JF
authors.lastname: Simard
authors.affiliation: American College of Rheumatology, Atlanta, Georgia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Myslinski
authors.affiliation: University of Texas Southwestern Medical Center, Dallas.
authors.forename: Salahuddin
authors.initials: S
authors.lastname: Kazi
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001688:Biological Products / Q000627:therapeutic use; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008491:Medical Informatics Applications; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D058996:Quality Improvement; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data*; D012219:Rheumatology / Q000592:standards*; D014481:United States
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products