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screening: patients age $18 years with a BMI documented during the current encounter or during the previous 6 months AND with a BMI outside of normal parameters, a followup plan is documented during the encounter or during the previous 6 months of the current encounter 259,787 109,093 42.0 Preventive care and screening: patients ages 18–85 years who had a diagnosis of hypertension and whose blood pressure was adequately controlled (,140/90 mm Hg) during the measurement period 26,364 16,258 61.7 Gout: serum urate monitoring: patients age $18 years with a diagnosis of gout who were either started on ULT or whose dose of ULT was changed in the year prior to the measurement period, and who had their serum urate level measured within 6 months 5,205 1,614 31.0 Gout: serum urate target: patients age $18 years with a diagnosis of gout treated with ULT for at least 12 months, whose most recent serum urate result is ,6.8 mg/dl 1,250 786 62.9 Medication documentation: visits for patients age $18 years for which the eligible professional attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include all known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications’ name, dosage, frequency, and route of administration. 718,292 695,430 96.8 * RISE 5 Rheumatology Informatics System for Effectiveness; RA 5 rheumatoid arthritis; NQF 5 National Quality Forum; DMARD 5 diseasemodifying antirheumatic drug; TB 5 tuberculosis; DXA5 dual x-ray absorptiometry; MRI 5 magnetic resonance imaging; CT 5 computed tomography; BMI 5 body mass index; ULT5 urate-lowering therapy. † Lower percentage indicates high performance. 1872 Yazdany et al demonstrate that RISE is capturing the full spectrum of medications used in RA. Work is ongoing to further refine and validate medication information, including initiation and discontinuation dates and ensuring that medications that may not be as reliably recorded in the EHR, such as infusible biologic DMARDs, are captured. In addition, tuberculosis screening (NQF 2522) is an example of a patient safety measure. Our experience validating this measure suggests that lower performance on this measure indicates both a gap in quality and the fact that reliably capturing TB screening in practice requires further work to ensure accurate data capture (2). Efforts are ongoing to improve mapping and further validate all quality measures in RISE. For clinicians, RISE provides new opportunities to participate in efforts to improve the quality of care in rheumatology. Locally, the RISE user interface allows rheumatologists to track their performance on quality measures in conditions such as RA, gout, and osteoporosis. RISE allows rheumatologists to not only participate in national quality reporting programs such as PQRS, but also provides critical data analytic capacity to facilitate rapid-cycle quality improvement. Clinicians participating in RISE can run reports to view their performance on quality measures, and compare these data to others in their practice as well as against both the registry mean and national benchmarks. This marks a shift away from previous approaches to quality measurement, which have largely relied on administrative claims data or chart review. Limitations of claims data have included the lack of detailed clinical data and the sometimes significant delay in aggregating results; similarly, chart reviews required a significant time investment which impeded rapid-cycle quality improvement. By aggregating up-to-date EHR data and passively collecting more detailed
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