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quality measures, performance means across the registry, and practice- and clinician-level performance. Participating practices can also run customized queries on their own patient population and perform basic data analyses. For example, practices can run a query to identify all patients with a specific diagnosis code or who are taking a specific medication. These data can then be used for quality improvement activities or for local research purposes. Privacy and waiver of informed consent. RISE is a QCDR. The QCDR framework was introduced for the PQRS in 2014 and allows the collection of data without patient informed consent for the purpose of disease tracking and to foster improvement in the quality of care (1). The Centers for Medicare and Medicaid Services (CMS) have the ability to access Medicare patient data in RISE for quality reports through CMS oversight authority. For non-Medicare data, CMS may request the QCDR to mask protected health information (PHI) when aggregate data are requested. The Western Institutional Review Board (IRB) reviewed RISE and determined that because RISE is a quality improvement registry focused on health care delivery and on measuring and reporting data for clinical, practical, or administrative uses, individual practices do not need IRB approval or patient consent to implement RISE. The RISE data extraction protocol is Health Insurance Portability and Accountability Act (HIPAA) compliant. When a patient’s information is uploaded, PHI is stored separately. Any data used by third parties for research are de-identified and aggregated. However, participating practices can access their own PHI data and use these data for their clinical and quality improvement needs and for reporting quality measures to CMS. Quality measures and reporting. As a QCDR, RISE helps practices report clinical quality data to the PQRS program. Significance & Innovations The Rheumatology Informatics System for Effectiveness (RISE) registry is a novel electronic health record (EHR)–enabled registry that passively extracts EHR data from individual practices, aggregates and analyzes these data centrally, and feeds this information back to clinicians as actionable data for quality improvement using a web-based interface. RISE’s clinical informatics structure was designed to be agnostic to the EHR system used by rheumatologists, and can be adapted to draw data from most certified systems. Performance on quality measures across RISE practices presented here provides a useful benchmark for rheumatologists seeking to improve quality in their practices. Address correspondence to Jinoos Yazdany, MD, MPH, Division of Rheumatology, University of California, San Francisco, Box 0920, San Francisco, CA 94143-0920. E-mail: jinoos.yazdany@ucsf.edu. Submitted for publication May 25, 2016; accepted in revised form September 13, 2016. Using RISE Registry to Improve Quality of Care 1867 This reporting allows eligible professionals to avoid negative payment adjustments in 2017. In addition, submission of PQRS data through RISE also satisfies an objective of the Meaningful Use program: reporting to a specialized registry. By fulfilling this Meaningful Use objective, RISE helps practices further avoid reporting penalties. Research data repository. In addition to quality measurement and reporting, RISE serves as a resource for research. Both structured data (laboratories, medications, problem lists) and unstructured data (i.e., text from clinical notes) from the EHR are available for analysis. Research requests undergo formal committee review for feasibility. The ACR has contracted with 3 data analytic centers (University of California, San Francisco, University of Alabama at
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