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Rheumatic Diseases, Wichita, Kansas; 8 Esi M. Morgan, MD, MSCE: James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; 9 James C. Oates, MD: Medical University of South Carolina, Charleston; 10Catalina Orozco, MD: Rheumatology Associates, Dallas, Texas; 11Andreas Reimold, MD: Dallas Veterans Affairs Medical Center and University of Texas Southwestern Medical Center, Dallas; 12Julia F. Simard, ScD: Stanford School of Medicine, Stanford, California; 13Rachel Myslinski, MBA: American College of Rheumatology, Atlanta, Georgia; 14Salahuddin Kazi, MD: University of Texas Southwestern Medical Center, Dallas. Dr. Yazdany has received an independent research award from Pfizer. 1866 information back to clinicians as actionable data using a web-based interface. RISE aims to decrease the burden of data collection on practices, to streamline participation in federal quality programs, and to facilitate local rapid-cycle quality improvement by providing continuous performance feedback and benchmarking. In 2014, RISE passed a critical milestone and was designated as a federally Qualified Clinical Data Registry (QCDR). The American Taxpayer Relief Act established the QCDR quality reporting option, allowing physicians to submit data for the Physician Quality Reporting System (PQRS) directly through registries (1). Because data collected through QCDRs are meant to improve quality, there is a waiver of individual patient informed consent for registry data capture. All RISE data used for research are de-identified. Moreover, RISE can be used to fulfill a meaningful use objective measure (reporting to a special registry), and is being developed as a tool for maintenance of certification. As the transition to a valuebased system of reimbursement advances in the US, RISE will allow rheumatologists to track their performance on measures of quality of care and efficiency. RISE will also serve as an important tool for research in rheumatology. In this paper, we present the informatics structure of RISE, provide an overview of the type of data currently available to advance rheumatology care and research, report early results on quality measures, and share our vision for the future of the registry. MATERIALS AND METHODS RISE informatics structure. RISE is an EHR-enabled registry that automatically extracts data from individual practices’ EHRs on a scheduled basis and transfers these data to a central data warehouse. RISE has been constructed to minimize impact on practice workflow. No data entry into a separate database is required; instead, RISE collects data that are entered during the course of routine clinical care into the EHR. This is made possible through technology that uses a lightweight connector, installed locally, to establish a connection between the practice and RISE (Figure 1). RISE can connect to most certified EHR systems in the US; currently, the registry can map to over 30 different EHRs used by rheumatologists. Once an EHR is connected, the RISE data-mapping team works to identify participating clinicians and their patients and creates an initial EHR data extract. Practices then spend 6–101 hours validating data elements and quality measure performance data before moving into full production. This latter step allows RISE to customize data capture to the particular EHR configuration and workflow within each practice. Once data mapping is complete, further time commitment from practices will only be required if there are data aberrancies or new measures that require mapping. Data contributed to RISE are cleaned and analyzed centrally and feed a performance dashboard. Rheumatologists can access their practice dashboard through a web-based interface, where they can view national benchmarks for
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