What are the goals of the AQUA Registry?
The AQUA Registry's goal is to advance urologic care by providing physicians with the essential infrastructure and information they need to improve their clinical practices and patient outcomes. Initially, the registry will focus on prostate cancerwith plans to expand to other urological conditions.
How many sites are participating?
As of November 2015, the AQUA Registry covers more than 70 practices from 33 US States and territories from private practices to large health systems and academic centers. Initially the goal is to enroll at least 100 practice sites by the end of 2016. The Registry's long-term goal is to include every urologic practice in the United States.
Are you collecting data on newly diagnosed or established prostate cancer patients?
Data sets are being collected on newly diagnosed patients.
Will this be a prospective or retrospective process?
Patients will be followed prospectively from the initial time of diagnosis. The extraction process my be validated by examining retrospective data, but it will not be reported in any quality metrics.
Are you collecting identifiable data?
Yes, identifiable data are needed to comply with the Centers for Medicare and Medicaid Services' (CMS) Physician Quality Reporting System (PQRS) requirements and to link with SEER and other repositories in the future. Identifiable information collected in the AQUA Registry is stored on a secure, HIPAA-compliant server with robust backup. Participant sites will only have access to their performance data, which will be benchmarked against comparison data aggregated at the national or regional level.
Do the patients in my practice need to provide informed consent to participate in the AQUA Registry?
No, patients do not need to provide informed consent, as the registry is considered part of quality improvement. However, any patient who wishes to participate in the Patient-Reported Outcomes program will be required to acknowledge the receipt of a patient information form.
Is the AQUA Registry IRB approved?
Yes, an independent institutional review board (IRB) oversees all aspects of the AQUA Registry including the patient reported outcome portion. The IRB waiver is available upon request.
What are the outcomes and measures?
Will you provide me with templates so I know which data needs to be entered?
Yes, templates you can use or modify are available. As more templates become available, they will be posted here as well. Templates will greatly facilitate the data reporting process for the AQUA Registry participants.
How will you pull the information that is related to the diagnosis but entered by another provider?
The AQUA Registry's software vendor, FIGmd pulls patient data based on the National Provider Identifier (NPI) number of the AQUA Registry's participating providers. If a patient sees two or more urologists who participate in the Registry, FIGmd will extract all of the diagnostic and treatment information from each urologist's EHR. FIGmd is currently working on a patient matching process that it can detect and link diagnostic and treatment data from the same patients visiting multiple practices.
What are the benefits of joining the Registry?
Participant sites enjoy many benefits:
- Comparison of cross-specialty practice patterns and outcomes
- Physician Performance Reports
- National benchmarks for diagnoses and treatments
- Physician reimbursement support
- Patient Reported Outcomes (PRO) portal
- Potential Maintenance of Certification (MOC)
- Meaningful Use compliance
What is the cost to participate?
Effective April 1, 2017 all new AQUA Registry subscriptions are subject to an installation fee of $500 per practice for practices with at least one AUA member and $1,000 otherwise. Contact AUA at 855-898-AQUA to learn more.
Is this Registry eligible for certifications and reimbursements?
In 2016, the AQUA Registry will apply to meet the Centers for Medicare & Medicaid Services' (CMS) requirements for a Physician Quality Reporting System (PQRS) and Qualified Clinical Data Registry (QCDR). CMS reporting would start later that year. In the future, AUA anticipates that members who participate in AQUA will also receive Maintenance of Certification (MOC) credits from the American Board of Urology.
How involved does the practice manager have to be in the AQUA Registry?
The practice manager will need to participate in at least two to three calls with FIGmd and/or AQUA Registry staff to review reports until the mapping process is validated and complete.
Will a nurse or physician from AQUA help review reports?
Dr. Matthew Cooperberg is the AQUA Registry's physician advisor and provides clinical expertise and insight into data collection and reporting.
Can I use my own BAA?
What is the standard integration method used by FIGmd?
FIGmd uses the data-pull model. In this scenario, FIGmd fully manages the reporting process, with minimal impact to the practice. The vendor installs software on the local practice's server, which queries the EHR's backend database and extracts relevant clinical data. This software runs passively in the background, typically during off-hours, and does not affect clinical workflows or EHR performance.
What is/are the other method(s) that can be used to retrieve data?
FIGmd uses the data-push scenario when the software installation is not possible. In this situation, the practice IT staff sends the Registry a file each month containing all of the required data. Additionally a private cloud option is available for healthcare providers in larger academic and health system environments who wish to participate in the AQUA Registry, but do not want to release identified data outside their networks.
How long will it take for the first initial data extraction to be completed after mapping?
Initially, it takes two to three weeks to collect the data. After data is collected, FIGmd reviews it with the practice and makes any necessary mapping adjustments.
Does the Registry require real-time access?
The Registry does not require real-time access. The data pull runs early in the morning (between midnight – 6 a.m.) so it does not inconvenience the participating sites.
How are outcomes reported?
Sites will access real-time data summaries using a secure log-in. Each practice and physician will receive a benchmark report with comparisons with the national benchmarks. In early 2017, the AUA plans to publish the first national AQUA Registry report, Prostate Cancer Diagnosis, Treatment and Outcomes in the United States.
What other resources are needed?
Minimal time is required; local practice IT burden is estimated to be 30-40 minutes for software installation. FIGmd works directly with each practice's IT department to complete the mapping integration process. No ongoing maintenance or effort from local clinicians or support staff is required.
Where is the extracted information stored?
The Registry data are stored on Amazon Cloud, a secure, protected server that has been evaluated at the "moderate" level for Federal government systems. A full list of Amazon's security measures, including a white paper on Amazon's security processes, can be found on the Amazon Web Services (AWS) website. AWS complies with all applicable Health Insurance Portability and Accountability Act (HIPAA) regulations. AUA's utmost priority is to maintain the confidentiality of patient information.
Who will work with the practice to rectify any issues with the system?
FIGmd works directly with the practice and monitors the system. If it detects a problem, FIGmd will immediately notify the practice.
Which EMRs does FIGmd work with?
The software works with more than 60 EHR systems and can be adapted to any system with a backend database.
Will the AQUA Registry work with Epic?
Yes. AUA has several sites with Epic EHR software.
What happens if the EMR software changes to another vendor?
FIGmd will re-adapt to the new EHR.