GAO report: HHS should do more to drive registries

The Department of Health & Human Services (HHS) should do more to ensure that clinical data registries improve the quality and efficiency of healthcare for Medicare beneficiaries, according to a report from the Government Accountability Office (GAO).

A new rule on clinical data registries that was included in the 2014 Medicare Physician Fee Schedule to boost Physician Quality Reporting System participation might be too vague to provide meaningful data, according to the report.

HHS' flexible approach to clinical data registry implementation may "provide minimal impetus to (clinical data registries) to take full advantage of their specific opportunities to promote the quality and efficiency of care," the GAO report said.

GAO recommended HHS do the following:

• Focus its requirements for qualified clinical data registries on improving quality and efficiency;
• Require registries to demonstrate quality and efficiency improvements;
• Draw on expert judgment to monitor qualified registries;
• Reduce barriers to the development of qualified registries; and
• Include key data elements needed by qualified registries in Meaningful Use requirements.

The report also recommended that Meaningful Use requirements include standardized datasets to drive greater use of clinical data registries.

“Changes to EHR capabilities that would enable them to collect such data within existing standards are clearly feasible, but are not high priorities for providers and IT vendors because they are not included in the current set of Meaningful Use requirements."

GAO recommends that HHS (1) focus its requirements for qualified CDRs on improving quality and efficiency, (2) require qualified CDRs to demonstrate improvement in quality and efficiency, (3) draw on expert judgment to monitor qualified CDRs, (4) reduce barriers to the development of qualified CDRs, and (5) include, if feasible, key data elements needed by qualified CDRs in its requirements under the EHR incentive programs. HHS agreed with GAO's recommendations.