WASHINGTON – During the National Committee on Vital and Health Statistics’ two-day conference on meaningful use of healthcare information technology systems, Carolyn Clancy MD, director of the Agency for Healthcare Research and Quality, said physician practices and health systems eyeing bonuses under the stimulus package should begin now by setting up health registries with their health IT vendor.

Clancy suggested providers begin by collecting information on two to 20 chronic diseases, such as diabetes and heart disease, to focus on improving outcomes.

Joseph Mambu, MD, founder of Family Medicine, Geriatrics and Wellness in Lower Gwynedd, Pa., is ahead of the game.

Mambu’s practice is using a patient registry system from Dallas-based Phytel that helps them track patients with diabetes and heart disease, as well as those who need colonoscopies, PSA tests, pap smears, pelvic exams and mammograms.

Currently, the registry has to be populated manually. “It would be wonderful if the data in our EMR could be extracted and electronically populated into the registry, but it’s not as efficient as it should be,” he says. Perhaps in the future EMRs will be required to do this, but currently the majority of doctors are just trying to implement a basic EMR, he says.

Guy Mansueto, vice president of marketing at Phytel, acknowledges that there is still a disconnect between EMRs and registries. However, he believes they will be part of demonstrating meaningful use, even if this means operating them externally from an EMR for the time being.

“Meaningful use has to go beyond capturing information in a single system,” he says.

“The capacity to flexibly generate registries from EHRs is a critical function that they must have to achieve their potential benefit,” says Elliott Fisher, MD, a professor of medicine at Dartmouth Medical School and director of Health Policy Research at Dartmouth’s Center for the Evaluative Clinical Sciences.
Fisher believes registries should not function as standalone systems.

He suggest that key elements to modify the EMR may include:

Capacity to identify at the point of care all patients with specific clinical attributes;

• Capacity to prompt clinicians to confirm key attributes and request additional clinical or patient reported information;
• Capacity to track patients and outcomes and;
• Capacity to generate a database that can analyze the data.

Mambu cautions that in our quest to define meaningful use that we don’t lose sight of the big picture, which is about helping patients.

“All of this technology is just a tool,” he says. He hopes that using technology like patient registries will provide physicians with more time to re-connect with their patients and help them get to know them better.