New National Mental Health Registry in the Works

Nancy A. Melville

November 28, 2016

The American Psychiatric Association (APA) is developing a national clinical registry to provide psychiatrists with more efficient means to meet Medicare quality reporting requirements, to establish a database for mental health research, and ultimately to improve patient outcomes.

"We are pleased to offer this important tool to help psychiatrists meet new quality reporting requirements and maintain professional recertification, and we are excited about the research potential of this valuable resource for our patients and for the nation," Saul Levin, MD, the APA's CEO and medical director, said in a statement.

The registry, known as PsychPRO (Psychiatric Patient Registry Online), is designed to provide psychiatrists with an easy method for avoiding payment penalties that are associated with failure to meet the quality reporting requirements set by the Centers for Medicare & Medicaid Services.

The system's software will generate automated reports to allow psychiatrists to submit performance-in-practice data for receiving American Board of Psychiatry and Neurology Maintenance of Certification Part IV credit.

Psychiatrists will also be able to compare the performance and outcomes of their own practices with those of similar practices in broader populations, ranging from local to national levels.

"The administrator in a hospital system, for instance, could look at how the system compares on a quality basis in customer care, so they can know where they stand and where to improve," Colleen M. Coyle, APA general counsel, told Medscape Medical News.

"The registry will be able to show deidentified data nationally, but we won't be providing any data allowing systems to compare directly with other systems," she said.

Broad-Spectrum Approach

Most existing clinical registries in psychiatry are disease-specific. For example, the National Network of Depression Centers focuses on depression. By contrast, PsychPro will include data that span the spectrum of mental illness, Coyle said.

"There are registries specifically for conditions such as depression and schizophrenia, but this will encompass all mental health disorders," she said.

The registry is expected to grow to become an essential research database to help with clinical trials and mental health studies.

Participants in the registry will initially need to be set up with electronic health records (EHRs). The APA expects to eventually accommodate those who do not use EHRs, either through the use of a Web-based portal or with paper-and-pencil information that is scanned into the system.

With respect of the confidentiality of data, psychiatric practices that join the registry will enter into an agreement that includes a business associate agreement that is compliant with the Health Insurance Portability and Accountability Act. No identifiable provider or practice data provided by psychiatrists will be published without permission.

The registry is expected to improve patient outcomes by giving clinicians the tools to track patients' symptoms over time and identify indicators of improvement, Gregory W. Dalack, MD, chair of the Department of Psychiatry at the University of Michigan, in Ann Arbor, who is a member of the APA Registry Oversight Workgroup, told Medscape Medical News.

"The registry will broaden the use of patient-reported outcomes and measurement-based care. Presently, use of standardized measurements with patient self-report on symptom and outcome measures is not very widespread in psychiatry, [but] consider how hard it would be to effectively manage diabetes or hypertension if there were not partnership with patients to measure their blood glucose or blood pressure in between visits," he said.

Patients will provide input on the status of their mental health.

"Having patients report how they are doing via measures of anxiety, depression, etc, will help psychiatrists have one other measure to use in assessing how patients are progressing," Dr Dalack said.

"These measures are not the be-all and end-all of clinical management; that still requires the full breadth of a clinical assessment. But they will provide additional data points for both the psychiatrists and the patients to assess and chart their course," he added.

Ease Reporting Process

Although the registry is in its early implementation stage, the Sheppard Pratt Health System, in Baltimore, Maryland, which is the largest private, nonprofit provider of mental health and substance use services in the country, has signed on to become the first major health system to join PsychPRO, with 83 psychiatrists enrolled as registry participants.

"We believe that this registry will improve the quality of mental health care in the US by allowing psychiatrists and other mental health providers to compare outcomes and develop best practices," Harsh K. Trivedi, MD, president and CEO of Sheppard Pratt, told Medscape Medical News.

"It will also allow patients to make more informed decisions about their care using outcomes data provided from the registry."

Dr Trivedi added that he expected the registry to significantly ease the process and stress in meeting data submission requirements.

"Most mental health providers currently submit data manually, which is a labor-intensive process. Sheppard Pratt Health System [typically] submits data electronically at our own expense and through a private vendor, [but] using PsychPRO will allow us to seamlessly submit data with less burden to the patient and the provider. Converting to PsychPRO will simplify the process of quality reporting," he said.

Information on the PsychPRO registry is available on the registry's website.

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