Before COVID-19, healthcare organizations already had an overwhelming amount of work in the area of reporting and quality measures. Add COVID-19, and now you have an even heavier reporting load.
Nordic recently introduced a way to automate the submission of data to registries with an application called Registry Direct. We sat down with Scott Rossignol, Director of Interoperability at Nordic, to have him explain the solution and the main applications for healthcare organizations.
If you want to learn more about Registry Direct, we have a brief overview video available. We'd also enjoy a chance to listen to your registry or other data submission needs.
[01:31] The problem that Registry Direct solves
[02:41] How Registry Direct integrates with EHRs
[03:57] Registries that Registry Direct can submit to
[04:23] Data validation
[05:30] The value that Registry Direct can bring to an organization
[06:37] Data privacy and HIPAA-compliance measures
[07:19] COVID-19-related reporting
[08:30] How long it can take to set up registry submissions
[10:08] How to stay up to date with the registries
[11:08] Summary of Registry Direct and next steps
John Pollard: Hello and welcome to this conversation about Registry Direct. My name is John Pollard. I am part of the podcast team at Nordic, and today I am joined by Scott Rossignol. Scott, welcome.
Scott Rossignol: Hey John. Thanks for having me.
John Pollard: Scott, tell us a little bit about yourself.
Scott Rossignol: Yeah. Hi, I'm Scott Rossignol. I'm a software developer and a director of interoperability here at Nordic. I am a former Epic implementer. I have seven Epic certifications. I’m proficient in a number of different software languages and have about 10 years in the healthcare industry.
John Pollard: Thanks Scott. Now tell us a little bit about Registry Direct. What problem are you trying to solve with Registry Direct?
Scott Rossignol: So, the problem boils down to the overhead that organizations face when they're participating in clinical quality programs. The goal of any clinical quality program is to report the information that you record in your EHR, the care that you're providing patients, and to understand if you're standardizing that care or what you can do to improve the care.
The existing solutions today on the market are difficult to set up. They're very costly. They're difficult to maintain year over year as specifications change, and really they're stuck in the '90s. They don't make use of the electronic documentation that we have today.
So, Registry Direct tries to solve that problem by connecting directly to the EHR and pulling information so that we can take on those problems for the health system, rather than forcing them to do it themselves.
John Pollard: Got you. So, you are automating processes, so to speak at a highest level. Is that true?
Scott Rossignol: Yeah, exactly. We're taking a lot of the work that the organizations have to do, and we're taking it on ourselves, which means we only have to do it once instead of each health system having to do it themselves.
John Pollard: Sounds great. Now how does that work for people that want to understand what's actually happening underneath the hood? What is going on with the technology? Tell us more about that EHR integration and such.
Scott Rossignol: Yeah. So, I like to use the hub-and-spoke model a lot here because Registry Direct is essentially the hub, and it connects out to each health system as a spoke, and it pulls that information in a standardized format. That standardized format is called FHIR, which we can talk about in a little bit. But what this means is that we're gathering information from each health system that signs up with us, and we're able to then take that information and parse it into the specifications that your registry requires.
So you provide information in a standard way that your quality department and your IT team doesn't have to really do very much set up for. We're able to grab that information automatically and transform it into the formats that you need. This also allows us to automate your process, so for example, we can generate extracts on patients without you actually intervening on a regular schedule. We can also upload that data automatically for you so you don't even have to think about it. You can log into the registry website on a monthly or a weekly basis and see your data uploaded automatically.
John Pollard: One question on that, can you give us an example of the type of registries that you'd be submitting to?
Scott Rossignol: Sure. The American Heart Association is one of our partners, and we submit data to their Get With The Guidelines heart failure registry. This is a registry that a large number of organizations submit to today. The information that you submit is used in your joint commission compliance reporting, and it's typically a really important tool that you can use to standardize your heart failure care.
John Pollard: And then you mentioned that you can automate this submission a little bit, or actually maybe a lot of it. And one question might be how do the organizations verify that the data being sent is accurate?
Scott Rossignol: Yeah, data validation has been a challenge for EHRs since they started reporting this kind of information. The great thing with Registry Direct is that we provide the output information to you in a format that you can easily look at and understand compared to the manual processes that you might do today. So we can actually look at patients that you've reviewed for past submissions, and Registry Direct can provide you an output that you can validate against your past submissions. This means that you can actually look at your information without doing additional work, pulling information from the chart, and you can verify that the information Registry Direct provides is the same as what you manually would have provided.
We also have more automated validation processes, and every time we implement a new registry with any organization, we go through a couple of weeks of ensuring trust and validating the confidence in the Registry Direct outputs.
John Pollard: Fantastic. So how would you quantify the value that this type of a solution might bring to an organization?
Scott Rossignol: From the quality standpoint, there's a lot of value in that you can free up your staff to work on other things. There's no more need for manual abstraction. You can simply validate the outputs from Registry Direct and ensure that the data you're uploading is accurate. So you can spend a lot less time in the charts of each individual patient and a lot more time looking at the care that your organization is providing, working with your clinicians, or talking directly with your patients.
From the IT standpoint, we're talking about a single connection with Registry Direct that can support a large number of outputs, a large number of different registries. So, the old days of creating a SQL extract or a CSV file that contains information for each individual registry that you submit to, or even various reporting that you need to do internally, that's something that Registry Direct can solve for you in a lot faster time. And you do not need to worry about the yearly maintenance that's required when specifications change.
John Pollard: For those who have concerns about data privacy or compliance with HIPAA, how do you address that with Registry Direct?
Scott Rossignol: Sure. So Registry Direct uses FHIR APIs, which are HIPAA-compliant and integrate directly with your EHR. So, any time we access data within your EHR, you can actually report on that and see audit logs of anything that happens. In addition, the only reason we access your data is for generation of the extract and upload of that data to the registry, and we get rid of that information from our servers immediately. We do not store data, and we don't use it for any other purposes besides the creation of your extracts.
John Pollard: Sounds like you have it covered. Fantastic. Now, right now it is May 12 when we're recording this conversation, and we are in the middle of, in Wisconsin, it's a stay-at-home order, many places are in sort of lockdown or quarantines. How might this solution apply to organizations that have to do reporting related to COVID-19?
Scott Rossignol: This goes back to that single setup idea where Registry Direct can provide a single setup that connects with health systems and allows those health systems to rapidly report data. So through Registry Direct, to report on COVID-19 data, you can simply just request COVID reports instead of having to set up all the reporting yourself. Instead of having to rely on your EHR’s tools, you could just ask for a new set of reports from Registry Direct for COVID-19 and specify which data you need from us, and we can create that for you. Again, this allows us to take on that process of maintaining, of automatically pulling data, of automatically submitting the data for you, and allows you to focus more on the care for your patients.
John Pollard: So, for an organization that is trying to set up Registry Direct, how long does it take to set up one registry submissions?
Scott Rossignol: Yeah, set up can depend heavily on what the registry requires. Registry Direct is able to communicate with EHRs and pull information that's mapped in what we call standard terminologies. So a lot of the information that you report today, like medications, allergies, ICD-10 codes, immunizations, all that information is already mapped within your system and set up and ready to go. What that means is that your setup to report a large amount of data, requires very little input from your IT team or your quality team.
There are some connectivity steps that we get through. That typically takes a couple of weeks working with your IT team to get everything set up, to ensure that we can authenticate and log our access into your system appropriately. But the setup of Registry Direct, we estimate takes less than 15 hours of your time.
John Pollard: And then if you had one registry set up and you added additional registries in the future, would that be similar, or would that be a lighter load?
Scott Rossignol: A much lighter load. So, once you have connectivity, you never need to reestablish connectivity. We can always connect and grab information. The only time that we need to make updates are to actually map information from your system is when we're looking for information that's not standard, such as different observations or recordings like a physical therapist's documentation or a particular note type that you'd want us to include in our reporting.
John Pollard: And you actually just bring up an interesting point. So as these registries and maybe the requirements change, what does that mean for the organization then? What kind of work do they have to do to keep up to date with these changes in the registries?
Scott Rossignol: So Nordic is going to maintain the requirements and will ensure that every time you submit, you're submitting the data that meets specifications for any given registry at that time period. What we'll do is we'll create release notes, and we'll let you know if there's any setup that's needed on your end to add new information into your extracts or to just basically report any new data elements, and we'll let you know exactly what set up needs to be done.
John Pollard: So, the short answer is basically you guys are going to take the load of keeping Registry Direct up to date so they don't have to worry too much about that, and you'll keep them informed.
Scott Rossignol: Exactly. There are some steps that EHRs do have to take from time to time to submit new information to Registry Direct, but we're always going to let you know that well in advance so that you can make those updates or you can choose not to.
John Pollard: So, to sum this up a little bit, tell us in a nutshell, what Registry Direct does.
Scott Rossignol: Registry Direct allows you to automate your registry reporting process through the use of different technologies that connect with your EHR and pull data automatically.
John Pollard: And if somebody were interested to get started with this sort of a thing, what would be the first step that they would need to take?
Scott Rossignol: Well, we'd love to have a conversation. You can reach out to us on the website, or you can email our firstname.lastname@example.org, and we can get started with that discussion.
John Pollard: Thanks, Scott, so much for sharing your insights and expertise on Registry Direct. Thank you for your time.
Scott Rossignol: Well, thanks, JP. I really appreciate the opportunity.