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AUA Quality Registry (AQUA) FAQs

AQUA - AUA Quality Registry

Registry Overview

What is the AUA Quality (AQUA) Registry?

The AQUA Registry is a national Qualified Clinical Data Registry (QCDR) designed for urologists and other urologic care providers to monitor, track and report performance at both practice and provider levels.

What are the goals of the AQUA Registry?

The goal of the AQUA Registry is to advance urologic care by providing physicians with the essential infrastructure and information they need to improve their clinical practices and patient outcomes.

How many providers are participating?

As of the end of 2019, there were approximately 1,800 urologic care providers actively participating in the Registry across the nation.


What urologic conditions are included in the AQUA Registry data?

The AQUA Registry focuses on ten major urologic conditions including prostate cancer, advanced prostate cancer, bladder cancer, benign prostatic hyperplasia (BPH), urinary stones, testosterone replacement therapy, stress urinary incontinence (SUI), cryptorchidism, hypogonadism, azoospermia and vasectomy. The AUA plans to expand to other conditions in the future as new measures are developed.

What is the time commitment for the practice representative?

The practice representative will need to participate in at least one to two calls per quarter with FIGmd and/or AQUA Registry staff to review measures until the mapping process is validated and complete.

Will I receive help reviewing the measure scores for my practice?

Yes, a client account manager provides clinical expertise and insight into data collection and reporting. If required, a physician advisor may be consulted.

Are data reviewed prospectively or retrospectively?

Patients are followed prospectively from the initial time of diagnosis. The extraction process may be validated by examining retrospective data, but such data 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) Merit-based Incentive Payment System (MIPS) 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. Practices 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.

What if my patient does not want their information shared with the Registry?

Patients who would like to opt out of the AQUA Registry should let their urologist know in writing. Urologists will notify the AQUA Registry, and data for the patient will be removed going forward.

Is the AQUA Registry IRB approved?

Yes, an independent institutional review board (IRB) oversees all aspects of the AQUA Registry. The IRB waiver is available upon request.

What measures are available on the dashboard?

Review the available measures on the AQUA QCDR Measures page.

Do you provide templates so I know which data need to be entered?

Yes, prostate cancer templates you can use or modify are available on the AQUA Registry Resources page. 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 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.

Participation Costs/Benefits

What are the benefits of joining the Registry?

Participants enjoy many benefits:

  • National benchmarks for diagnoses and treatments
  • Urology-specific measures
  • Practice and physician performance indicators for quality improvement
  • Merit-based Incentive Payment System (MIPS) reporting to CMS
  • Promoting Interoperability credit for transmitting data to a Clinical Data Registry
  • Practice Assessment Protocol (PAP) credit for ABU's Life Long Learning Program (formerly MOC). To claim the credit, providers must meet eligibility requirements.

Is the Registry eligible for certifications and reimbursements?

The AQUA Registry meets the Centers for Medicare & Medicaid Services' (CMS) requirements for quality reporting and EHR programs. CMS reporting would start later that year. Eligible urologists who utilize the interactive dashboard and reporting tools can receive Practice Assessment Protocol (PAP) credit for the Life Long Learning Program (formerly MOC) made available through the American Board of Urology (ABU).

What is the cost to participate?

Participation fees are assessed on an annual (calendar year) basis. Pricing varies by subscription level, AUA membership status and practice size.

All new AQUA Registry subscriptions are subject to an integration fee of $500 per practice for practices with at least one AUA member and $1,000 for practices without AUA members. Email AQUA@AUAnet.org to learn more.

Visit the Sign Up for AQUA page to review the benefits and pricing for each subscription level.

Are there any discounts?

Practices enrolled in the Elite subscription level may be eligible for group discounts. Contact the AQUA Registry Team to learn more.

How do I renew my AQUA Registry subscription?

The subscription renewal process begins each October for the following year with an email to the practice contact. The practice contact will then select the appropriate subscription level on the provided Appendix 2 Form. The Appendix 2 Form, along with a list of participating providers, must be emailed to AQUA@AUAnet.org by December 31.

Billing and Payments

What is the billing cycle?

Your practice will receive an annual invoice including all participating providers within your practice. Invoices are sent via email in late January. You will also receive an invoice when new providers are added throughout the year. Payments are due within 30 days of the invoice date.

The information on my invoice is incorrect. How can I correct this?

Email the correct information to AQUAbilling@AUAnet.org.

How do I review or change the participating providers within my practice?

The list of providers currently associated with your practice is available on your practice dashboard. You may also email AQUAbilling@AUAnet.org.

Providers can be added to the Registry through your practice dashboard or by emailing AQUA@AUAnet.org or AQUAbilling@AUAnet.org at any time throughout the year.

The list of providers currently associated with your practice is available on your practice dashboard. You may also email AQUAbilling@AUAnet.org.

To change a provider's status to inactive, email the provider's name and NPI number to AQUAbilling@AUAnet.org.

When will my practice be billed for newly added providers?

An invoice for additional providers will be emailed to the billing contact for your practice on the first of the month following the change, and payment will be due within 30 days of the invoice date.

Example: ABC Urology adds 2 providers on February 3. The invoice will be available on March 1 and the payment will be due by April 1.

How can I pay my invoice?

You may pay your invoice via credit card or a paper check. For credit card payments, please call the AUA customer service line (1-800-908-9414) to provide your card information. If you would like to submit a paper check, please mail your check to: American Urological Association Education and Research, Inc., P.O. Box 791080, Baltimore, MD 21279-1080.

Please be sure to include the invoice number on your check.

Frequently Asked Questions about FIGmd, the AQUA Registry Vendor

What is FIGmd?

FIGmd is the technical vendor contracted by the AUA to assist with the AQUA Registry operations. To learn more about FIGmd, please visit FIGmd.com.

Technical Process Overview

What is the standard integration method used by FIGmd?

FIGmd uses the data-pull model. In this scenario, FIGmd fully manages the integration process, with minimal impact on the practice. The vendor installs read-only software on the local practice's server, which queries the EHR's back-end database and extracts relevant clinical data. This software runs passively in the background, typically during off-hours, and does not affect clinical work flows or EHR performance.

What other methods 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.

When will my data be available on the dashboard?

Once the EHR integration process is complete, it takes seven to nine weeks to extract the data and provide the practice with the first dashboard report. FIGmd reviews the data with the practice representative and makes any necessary mapping adjustments. After the initial dashboard report, three to six measures will be available for review monthly.

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 practices. Extraction times can be adjusted to comply with your internal requirements.

How are performance scores presented?

Practices access data summaries through a secure, interactive dashboard. Benchmark indicators that compare performance scores against peers nationally are available at the practice and physician levels.

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 EHR integration process. The practice contact is required to participate in one to two quarterly calls to review the data mapping accuracy and ensure it is in accordance with the practice's documentation patterns and measure specifications.

Where is the extracted information stored?

The Registry data are stored on Google Cloud, a secure, protected server that has been evaluated at the "moderate" level for Federal government systems. Google's security measures can be found on the Google Cloud website. Google Cloud 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 AUA and the practice.

EHR Software

Which EHRs are compatible with the AQUA Registry?

Please refer to the list of EHR systems that integrate with the AQUA Registry on the Resources page. If you do not see your EHR on the list, please contact  AQUA@AUAnet.org to discuss other integration possibilities.

Does the AQUA Registry work with Epic?

Yes. AUA has several practices with Epic EHR software.

What happens if the EHR software changes to another vendor?

Please notify AQUA@AUAnet.org of any EHR changes.