August 2017

HIT Happenings: How to Make Registry Abstraction Less Stressful
By Richard A. Royer, MBA
For The Record
Vol. 29 No. 8 P. 28

Health care organizations can use data from clinical registries to measure their outcomes and performance against other provider organizations. But despite these potential benefits, there is one aspect of data registries that continues to be a thorn in the side of health care teams: the abstraction and reporting required for participation. Fortunately, there are strategies health care teams can adopt to make submitting registry data less of a headache.

Accurate information is required for clinical data registries to truly be useful tools for advancing health care. Therefore, health care professionals must be vigilant about adopting practices that promote data quality and accuracy. However, providers often struggle to find the time and resources to pull data from medical charts. The pressure of keeping up with abstraction and reporting is burdensome, so much so that registry abstraction often doesn't receive the attention it deserves.

Competing priorities and limited amounts of time and resources often cause registry abstraction to be put on the back burner. The fact that so many hospitals around the country are weeks, months, or years behind on data abstraction, with new charts piling up every day, is proof there are challenges to overcome in order to make registry participation successful.

Dedicated Staff
To make registry abstraction and reporting less painful, health care teams can build a dedicated team of individuals who can consistently support data abstraction efforts. This team might consist of HIM professionals who can help ensure data are being captured correctly and are easily accessible; external data abstraction experts who can perform abstraction and deliver reliable data; and internal quality team members who can manage reporting, data analysis, and quality improvement efforts.

Too often, abstraction is handed off to nurses or other staff who already have a full workload and simply cannot devote sufficient time to abstraction. Many of these individuals have little or no abstraction experience. Rather than treating abstraction as an add-on for a few unlucky team members, health care organizations need to put in place teams that will be able to devote time to making registry abstraction successful.

Develop a Process
Once there is a team of supporting players in place, the next step is to begin streamlining and simplifying the registry reporting process. To be successful, it is recommended providers enact the following tips:

• Be complete and accurate. Errors and missing components in data slow down the abstraction and reporting process. Data missing from medical charts cannot be abstracted or reported. To ensure correct data are available and easily accessible so reporting is not delayed, registry abstraction and reporting teams need to share reporting guidelines with the clinicians who document information in charts. If required data are continually missing from charts, teams can run reports, identify where breakdowns are happening, and work with clinicians to correct the problems.

• Use EMRs to capacity. Another way to improve efficiency and make reporting easier is to optimize EMRs. Following templates and using EMRs to guide documentation can help teams collect the right data for registry abstraction. HIM professionals can often help with EMR optimization across an organization.

• Read registry manuals. Those involved with registry abstraction and reporting should make time periodically to read registry manuals. Knowing the requirements for the registries makes it easier to comply with reporting guidelines. Teams should review information sent by registries (usually via e-mails and newsletters) and watch for registry abstraction guideline updates.

• Recruit staff that fits the abstractor mold. The shortage of experienced registry abstractors makes it difficult for health care organizations to fill specific positions. As a result, outsourcing abstraction can be beneficial. Nevertheless, when filling abstraction roles with internal staff (such as nurses and administrative staff), it's a good idea to look for individuals who exhibit resourcefulness, attention to detail, strong organizational skills, an ability to work independently, experience in key areas related to the registry, and exceptional time management abilities.

• Take advantage of learning opportunities. Many of the team members responsible for registry reporting are self-taught. If internal team members are stumbling through data abstraction and making mistakes, efficiency goes out the window and valuable time is lost. Staff members can perform better—and are less likely to feel overwhelmed by registry reporting demands—when they have opportunities to learn and perfect their skills. When abstractors attend monthly registry calls and annual conferences, they gather information they can use to perform abstraction better.

• Plan for abstraction disruptions. Teams should expect disruptions and be ready to make the appropriate adjustments to prevent registry abstraction from becoming derailed. Staffing shortages are an example of a common issue that can cause teams to fall behind. It's impossible to stay current on charts if abstraction gets put on hold every time a team member is out sick, on vacation, or removed from abstraction work for other reasons. Therefore, having a plan to deal with shortages and other distractions is a sound strategy to ensure abstraction never gets completely put on hold.

• Get support. Not every health care provider organization has staff with the know-how or bandwidth to perform internal abstraction and reporting. If working with data is outside a team's skillset or scope, relying on an external partner can alleviate stress and guarantee abstraction will be completed in a timely manner. With the right partner, health care providers can remove some of the weight of abstraction and reporting, gain insights for quality improvement, and discover financially sound strategies to improve patient outcomes.

Providers that utilize registries and make quality improvements increase their ability to earn payment reimbursements and avoid penalties. In some cases, registry participation is required for earning reimbursements or receiving accreditation. Patients also benefit from registries, which help providers learn about diseases over time, an important component of developing patient-specific, evidence-based treatment plans.

Ultimately, there are many positive reasons for health care providers to participate in registries. To make sure those positives are not overshadowed by the challenges, teams should look for smart solutions to make registry abstraction and reporting less stressful.

— Richard A. Royer, MBA, who has served as the CEO of Primaris since 2001, has extensive administrative health care experience and is actively involved in several statewide health care initiatives. In his more than 35 years of medical business experience he has held positions as CEO at Cuyahoga Falls, Ohio, General Hospital; executive director of Columbia Regional Hospital in Missouri; and founder and president of Avalon Enterprises, a medical financial consulting firm.