Frequently Asked Questions
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.
What is the AUA Quality (AQUA) Registry?
The AUA announced the development of AQUA Registry 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 will be the only specialty-wide, urologic disease focused registry in the United States.
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 web site.
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:
When will the AQUA Registry launch?
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 types of data will be collected?
Practice Level (combined and comparative) and Physician Level (individual practitioner)
Aggregated, de-identified data from participating practices will be provided for comparative purposes. Risk adjustment will be utilized whenever possible, but it is understood that collection of all pertinent risk adjustment variables may not be possible in the initial phases of the AQUA Registry. Practice-specific information will remain confidential. The goal of these measures is to provide quality improvement data to individual practices for their use. Individual, identifiable data will not be shared or publicized.
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 registry@AUAnet.org.