PRACTICE RESOURCES > AUA Quality Registry (AQUA)


AUA Quality Registry (AQUA)

As part of its ongoing commitment to improving the quality of care for patients with urologic disease, the AUA recently announced it is developing the AUA AQUA Registry.

The AQUA Registry will be the only specialty-wide, urologic disease focused registry in the United States and will be designed to measure and report health care quality and patient outcomes. Through the aggregation and organization of both clinician- and patient-reported data on diagnostic and therapeutic interventions, clinical and patient-reported outcomes and resource utilization, AQUA will provide the urologic community with a definitive resource for informing and advancing urology within the United States.

Starting with prostate cancer, the AQUA Registry will gradually expand to include other urological conditions.

AQUA Registry can be a powerful tool for urologists to observe the course of disease; understand variations in treatment and outcomes; examine factors that influence prognosis and quality of life; describe care patterns, including appropriateness of care and disparities in delivery of case; assess effectiveness; monitor safety and harm; measure quality of care; and compare themselves with their peers."

Dr. Gopal H. Badlani, AUA Secretary

 

The AUA AQUA Registry is being developed under a sophisticated information technology infrastructure and will be implemented in a phased manner over the next three years in terms of number of participating practices, scope and functionality.

Phase one (design and testing) of the Registry is underway and began January 2014. Work during this phase will focus on data validation and quality, measures validation, and EHR integration success.

Phase two (pilot phase), is scheduled to begin July 2014, with the launch of a fully operational AQUA Registry scheduled for July 2015.

Phase 1 – Design, build, test (beta)
January 2014

Phase 2 – Pilot
July 2014

Launch – Regular operation
July 2015

 

Once the beta development and testing phase is complete and the pilot phase begins, participating sites will begin contributing data on an ongoing basis in order to create a robust, longitudinal registry for quality improvement and research purposes.

Participation criteria will expand during each phase, and AUA will make announcements as we open the Registry for wider participation, so please monitor the AUAnet.org web site and AUA publications for new information.

For further information on how to participate, please email your name, practice name and contact information to aqua@AUAnet.org.

 

Requirements

To participate in the AQUA Registry, your urology practice must:

  • Currently be providing prostate cancer care
  • Currently being using an electronic health record (EHR) system
  • Complete a Business Associate/Data Use Agreement

Prostate Cancer Care Provider

AQUA is the first specialty-wide urologic registry at a national level, designed to provide data to help identify trends in the diagnosis and treatment of urologic conditions. As such, AQUA will initially focus on prostate cancer, as it is one of the most common conditions treated in the field of urology. It will then gradually expand to include other urological conditions.

EHR System

As a requirement for participation, practices must currently be using and EHR system. For those using an EHR system, the Registry is designed to fit seamlessly into your clinical practice workflow and will minimize time spent on data entry and produce cleaner data through EHR data integration.

AUA chose this course of action as most Medicare reimbursement eligible providers are moving to comply with the Centers for Medicare & Medicaid Services (CMS) Meaningful Use criteria by January 2015, which is the timeframe the AQUA Registry will open for wider participation.

Business Associate/Data Use and Registry Participation Agreement

When a practice decides to participate in the Registry, it will be required to sign a Business Associate/Data Use Agreement and Registry Participation Agreement. The Agreements mostly addresses HIPAA requirements for the collection of de-identified patient data as well as outline what the AUA agrees to provide and what the participating practice agrees to provide.

Benefits

Benefits of participating in the AQUA Registry include:

  • Physician reimbursement support
  • National benchmarks for diagnosis and treatment
  • Cross-specialty practice pattern and outcome comparison

Physician reimbursement support

As health care in the United States continues its rapid transition to a value-based system in which providers are paid based on treatment results, quality of care, efficiency and patient satisfaction, the AQUA Registry will provide a means for providers to track these parameters.

AQUA will apply to meet CMS requirements for Physician Quality Reporting System (PQRS) and Qualified Clinical Data Registry (QCDR) reporting starting in 2016. Use of the registry under PQRS and QCDR will avoid negative financial reimbursement from CMS.

PQRS was introduced by CMS to evaluate patient outcomes and quality of care. PQRS registries, and now QCDRs introduced as of January 2014, are considered key vehicles to automate the reporting of data to qualify for Medicare reimbursement. Private payers are also moving to collect these quality measures to evaluate agreements with providers.

National benchmarks for diagnosis and treatment

To date, there is no specialty-wide urologic disease registry at the national level. Facility- and region-specific prostate cancer registries exist at the University of California, San Francisco (the Cancer of the Prostate Strategic Urologic Research Endeavor, aka CaPSURE), and the University of Michigan (the Michigan Urological Surgery Improvement Collaborative, aka MUSIC). Experience and expertise gained within the urology community from the development of these registries, combined with disease expertise of AUA leaders in prostate cancer, will inform the design of the national registry at the AUA.

Cross-specialty practice pattern and outcome comparison

With participation from urology practices nationwide, data from the AQUA Registry will be used to generate regular feedback reports summarizing local practice patterns and treatment outcomes, and to compare a practice's own patterns with those of a number of others across the nation. The reports could also be used to identify process-of-care variables that may correlate with key patient outcomes.

Data will be housed in a secure, protected server and in compliance with all applicable regulations. It is of AUA's utmost priority to maintain confidentiality of patient information.

Costs

Participation in the Registry during the initial years is free. Any fee introduced in the future would be communicated in advance through the AUA and may be used to cover individual user access to the information system or mapping to EHR data fields.

Join

If you are interested in participating and have not been contacted by the AUA directly please email your name, practice name and contact information to aqua@AUAnet.org.

 

The AUA Quality (AQUA) Registry
An AUA Board-Approved Initiative

Collecting Meaningful Data to Bridge the Knowledge Gaps around Urology

 

The AQUA Registry

As part of its ongoing commitment to improving the quality of care for patients with urologic disease, the AUA is developing the AUA Quality (AQUA) Registry. This is the first specialty-wide urologic registry at a national level, designed to measure and report healthcare quality and patient outcomes. It will also provide data to identify patterns, trends and outcomes in the diagnosis and treatment of prostate cancer. The AQUA Registry's clinical focus will be on the longitudinal follow-up of patients with newly diagnosed prostate cancer and include a personalized portal for patients to report self-perceived outcomes on their quality of life.

Quality Care through Comparative Evidence

Initially focusing on prostate cancer and then expanding to other urologic conditions, the AQUA Registry will, for the first time, enable urologists to review their practice patterns and outcomes in comparison with their peers. Starting in 2015, the AQUA Registry will provide urology practitioners with patient outcomes and healthcare quality metrics specific to prostate cancer using data gathered from physician and practice levels as well as patient reports. The AQUA registry will then gradually expand to include other urological conditions.

A Physician-Friendly System

The AQUA Registry is designed to be physician-friendly. With little data entry burden to physician offices staff, clinical and patient data will be extracted, transformed and loaded into the AQUA Registry from the practice sites' electronic health record system.

AQUA Data Capture Flowchart

How AQUA Registry Data Will Be Used

National and comparative data generated by the AQUA Registry will support guideline-informed physician practice, and evidence-based patient decision support mechanisms. It will provide participating urologists feedback regarding their individual- and/or practice-level performance on a range of process and outcome quality measures, benchmarked against their peers at national and regional levels. For physicians, these data will help them meet both the Centers for Medicare and Medicaid Services' Physician Quality Reporting System (PQRS) reporting and potentially regional and national certification requirements. For government policy-makers, the AQUA Registry will provide further understanding around patient safety, costs of care and system effectiveness.

Why Urologists Should Support the AQUA Registry

The healthcare environment is transitioning from volume-based to value-based payment for care. The AQUA Registry will ensure that urologists, rather than other parties, are identifying what works best and for whom.

Privacy Policy

Identifiable information collected by the AQUA Registry will be stored in a secured area, and only participant sites can see their performance with benchmarking comparisons of national or regional statistics.

Summary

The AQUA Registry is being developed under a sophisticated information technology infrastructure and will be implemented in a phased-in manner over the next two years in terms of the number of participating practices, scope and functionality. The initial design and testing phase began at February 2014 with the participation of 10 sites. The pilot phase is expected to begin summer 2014. Through the aggregation and organization of both clinician- and patient-reported data on diagnostic and therapeutic interventions, clinical and quality of life outcomes and resource utilization, the AQUA Registry will provide the urologic community with a definitive resource for informing and advancing urology.

Preparation and Implementation Period for AQUA

For more information, please contact the AQUA Registry Team: aqua@AUAnet.org or visit the AQUA kiosk at the 2014 AUA Annual Meeting, Hall C Lobby or visit the AQUA website: www.auanet.org/AQUA.

What is a clinical data registry?

A clinical data registry is an organized data system that collects uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease or condition, and that serves one or more predetermined scientific, clinical, or policy purposes. Source: Gliklich RE, Dreyer NA, eds. Registries for Evaluating Patient Outcomes: A User's Guide. (Prepared by Outcome DEcIDE Center [Outcome Sciences, Inc. dba Outcome] under Contract No. HHSA29020050035I TO1.)

Clinical data registries have been identified as an effective tool to measure the quality of care.

How is a registry used?

A patient registry can be a powerful tool to:

  • Observe the course of disease
  • Understand variations in treatment and outcomes
  • Examine factors influencing prognosis and quality of life
  • Describing care patterns, including appropriateness of care and disparities in the delivery of care
  • Assess effectiveness
  • Monitor safety and harm
  • Measure quality of care

What is the AUA Quality (AQUA) Registry?

The AQUA Registry will be the only specialty-wide, urologic disease focused registry in the United States.

Its development was announced by the AUA in October 2013. This initiative is part of the AUA's ongoing commitment to advancing urology to improve the quality of care for patients with urologic disease. The registry will be launched in 2014.

AQUA Registry is being developed to provide data to help identify patterns and trends in the diagnosis and treatment of prostate cancer, and eventual outcomes associated with treatment options. Starting with prostate cancer, the AQUA Registry will gradually expand to include other urological conditions.

Physicians and practices will submit data to the Registry via an extract from their electronic health record (EHR) system into the web-based data system. This will eliminate a data entry burden. The Registry will output reports that provide practices with comparison measures of the quality of care within their practice, against other practices, and benchmarked against data aggregated nationally.

Individual users will be assigned a secure login to be able to access their AQUA Registry accounts through a secure web site at any time. Through their account interface, users will be able to access the regularly delivered reports of measures generated from the data extracted from their practice's EHR system.

The AQUA Registry will be implemented in a phased manner over three years in terms of number of participating practices, scope and functionality. More information is available on our website.

What are the goals of the AQUA Registry?

The goals of the AQUA Registry are to aid in the advancement of prostate cancer care by providing essential infrastructure for urologist-led efforts to understand and improve clinical practice and outcomes. The potential areas for quality improvement and research include the following:

  • To identify indicators of necessary versus unnecessary utilization of testing for men at low-risk for metastatic disease, and optimize the use of appropriate radiographic staging evaluations among men with higher-risk cancers.
  • To identify treatment patterns for prostate cancer patients.
  • To measure treatment outcomes.

When will the AQUA Registry launch?

Phase 1
Design, build, test (beta)
January 2014
 
Phase 2
Pilot
July 2014
 
Launch
Regular operation
July 2015
 

Phase one of the AQUA Registry, design and testing, will begin in January 2014. Work during this phase will accomplish data validation and quality, measures validation, and EHR integration success.

Phase two, the pilot, is planned to begin July 2014, and the launch of a fully operational AQUA Registry is scheduled for July 2015. Participation criteria will expand during each phase, and AUA will make announcements as we open the Registry for wider participation, so please monitor the AUAnet.org web site and AUA publications for new information.

What are the requirements for participating in the AQUA Registry?

Your urology practice must be providing prostate cancer care.

When AUA receives a request from a physician or practice to participate, we will ask that a questionnaire be completed for the practice. This will help the AQUA Registry team assess the practice's readiness to begin, as well as engage the appropriate team members from the practice.

AQUA Registry participant sites must be using an electronic health record (EHR) system. The Registry is designed to fit seamlessly into clinical practice workflow. Utilizing an EHR system will minimize time spent on data entry and produce cleaner data through EHR data integration. AUA chose this as the course of action as most Medicare reimbursement eligible providers are moving to comply with the CMS Meaningful Use criteria by January 2015, which is the timeframe the AQUA Registry will open for wider participation.

Because the purpose of the registry is to provide the practice of urology with a valid data set for generating quality measure metrics, a commitment to contribute data will be important to participation. When a practice decides to participate in the Registry, it will be required to sign a Business Associate/Data Use Agreement and Registry Participation Agreement. The BAA/DUA mostly addresses HIPAA requirements for collection of de-identified patient data; the RPA addresses what AUA agrees to provide and what the participating practice agrees to provide.

Once the AQUA Registry completes the beta development and testing phase and begins the pilot phase, the expectation is that a site that signs an agreement to participate will be contributing data on an ongoing basis in order to create a robust, longitudinal registry for quality improvement and research purposes.

What is the cost to participate?

Participation in the Registry during the initial years will have no fee. Any fee that may be introduced in the future would be to cover individual user access to the information system and initial mapping to EHR data fields.

What are the benefits to participating in the AQUA Registry?

The AQUA Registry will apply to meet Centers for Medicare & Medicaid Services (CMS) requirements for Physician Quality Reporting System (PQRS) and Qualified Clinical Data Registry (QCDR) reporting starting in 2016. Use of the registry under PQRS and QCDR will avoid negative financial reimbursement from CMS.

Prostate cancer is one of the most common conditions treated in the field of urology, and the AQUA Registry will offer an opportunity for physicians and practices across the U.S. to collaborate by sharing data to develop an evidence base, in a way that has not been available before.

With the transition upon us to a value-based system in which health service providers are paid based on treatment results, quality of care, efficiency and patient satisfaction, the AQUA Registry will provide a means for providers to track such parameters from patient encounter information they already document, and adjust practices as necessary to maintain compliance with the highest of standards. PQRS was introduced by CMS to evaluate patient outcomes and quality of care. PQRS registries, and now QCDRs introduced as of January 2014, are considered key vehicles to automate the reporting of data to qualify for Medicare reimbursement. Private payers are also moving to collect these quality measures to evaluate agreements with providers.

To date, there is no specialty-wide urologic disease registry at the national level. Facility- and region-specific prostate cancer registries exist at the University of California, San Francisco (the Cancer of the Prostate Strategic Urologic Research Endeavor, aka CaPSURE), and the University of Michigan (the Michigan Urological Surgery Improvement Collaborative, aka MUSIC). Experience and expertise gained within the urology community from the development of these registries, combined with disease expertise of AUA leaders in prostate cancer, will inform the design of the national registry at the AUA.

Significant benefits of the AQUA Registry will be the AUA guideline-informed physician practice and evidence-based patient support to facilitate shared decision-making.

With participation from urology practices nationwide, data from the AQUA Registry will be used to generate regular feedback reports that summarize local practice patterns and treatment outcomes, and compare a practice's own patterns with those of a number of others across the nation. The reports could also be used to identify process-of-care variables that may correlate with key patient outcomes.

Data will be housed in a secure, protected server and in compliance with all applicable regulations. It is of AUA's utmost priority to maintain confidentiality of patient information.

How do I join the AQUA Registry?

If you are interested in participating and have not been contacted by the AUA directly please email your name, practice name and contact information to aqua@AUAnet.org.

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