AAN Develops Quality Improvement Registry

Pauline Anderson

July 01, 2016

The American Academy of Neurology (AAN) has developed a new registry with the aim not only to improve the quality of neurological patient care but also to benefit physicians economically.

The new Axon Registry now includes 22 quality measures, with a plan to add at least 10 more per year, said Bruce Sigsbee, MD, past president of the academy, who chaired the AAN's registry committee.

These measures cover conditions such as dementia, epilepsy, headache, Parkinson's disease, multiple sclerosis, and sleep apnea.

Some, said Dr Sigsbee, are broad measures, such as screening for falls, which is important in many neurologic disorders.

The Axon Registry aims to cater to the 27 or so different neurologic subspecialties, said Dr Sigsbee. "We are trying to develop measures that are relevant to just about everybody's practice. So there is something in the registry for the types of patients that an individual physician sees, and they will be relevant measures for his or her practice."

The registry might help reduce unnecessary and sometimes frustrating procedures, too. Dr Sigsbee used the example of screening for smoking and counseling patients on quitting the habit.

Although this is important under some circumstances, "for 99% of the patients sitting in front of me, that has no relevance; but I have to do it for every patient."

Using the registry shouldn't take up valuable time for a busy neurologist. The aim is to use software that can go into electronic health records and "capture information" with "fundamentally no change in what the physician does in day-to-day care," said Dr Sigsbee.

"It really does not affect what physicians do, and how they do it, during the day."

The Centers for Medicare & Medicaid Services (CMS) has approved Axon as a 2016 qualified clinical data registry. "That means that CMS has recognized this Registry as one that meets their requirements," said Dr Sigsbee.

This also means that physicians who use the registry can reap economic benefits regarding payments. "It will help protect reimbursements" for physicians, said Dr Sigsbee.

The registry helps physicians not only in the payment department but also in improved patient management. Using their Axon Dashboard, participating members can see how they're doing and whether they need improvement on a particular measure.

It "gives them the information they need to improve care," said Dr Sigsbee, adding that it "helps educate physicians about the kinds of things they really need to be thinking about for the neurological patients in front of them."

The registry has just reached a million visits, and there are now 350,000 patients in the registry, said Dr Sigsbee. It's projected that over 2 million patient records may be included by the end of the year.

The registry's pilot phase is still ongoing. The AAN board will meet in September to finalize a date for its formal release and a roll-out plan, said Dr Sigsbee.

The AAN is assuming the "multimillion-dollar" cost of the registry so there is no additional cost to individual physicians. Physician participation is voluntary.

Because the registry is considered "peer review," patient informed consent is not required. There is no way to identify a physician caring for the patients or the patients themselves, said Dr Sigsbee.

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