"Welcome to our company blog. Within these blog posts, we hope to share our insights on clinical quality management, the patient-centered medical home, chronic disease management in primary care, evidence-based medicine, and the use of technology in ambulatory care settings."

- David Morin, CEO and Donald Nease Jr., MD, Chief Medical Officer

It's not a registry! Better said, a Clinical Quality Management System, (CQMS) is more than a registry. Registries traditionally have been database tools built to track patients with chronic conditions. The idea was to take your group of patients with severe diabetes, heart failure, (insert chronic disease of choice here) and track them. How often are they seen? What's the status of their key measures? When did the last have their diabetic foot exam? Embedded in the above are a couple of assumptions... First, you've gotta assemble that list of patients. How you do it is huge. Do you do assemble it in the course of delivering care? Hey Maggie! Ms. Smith is really struggling with her asthma. Let's put her into the registry so we can track her more closely. That works, but man it's slow! Do you assemble the registry with billing data? (insert giant sucking sound here) Hoover up some billing data and you've got it, right? After all that's what the payors do to assemble those lists they send us, and we all know how accurate they are. Do you include all 250.xx? How did that patient get into the registry? They've just got glucose intolerance. You get my point. Second, once you've got that list, now you've gotta do something with them. Reporting! This is the golden deliverable of a registry. Give me the list of everyone that patients that are due for their diabetic foot exams! Oh crap! I just saw Mr. Powell, and he needed one. Reporting is great, but it doesn't do much for you when you are in the middle of patient care. The other big problem with reporting is you gotta capture the data that you want in the registry and get it into the registry. This is the "Oh crap! I just DID Mr. Powell's foot exam but I forgot to record it for the registry" problem. Registries require a lot of care and feeding. How is a CQMS different? It contains a registry, but an all-problem, clinician-verified registry. You don't decide how to populate it because you are building it every time you see a patient by recording, updating and correcting their problem list. A CQMS also should be able to deliver reports, but it should also give you something to act on when those patients come in. Mr. Powell, I see here on my Encounter Form that your due for your foot exam, so let's do that today. A CQMS should also be able to receive information from other data sources so you don't have to spend valuable time feeding it. Finally, we believe that a CQMS should integrate into your entire care delivery team. It does that by offering value to every member of the team. Clinicians get their encounter forms with reminders, Nurses get call lists of items that need attention, and administrative staff get reporting of quality measures tell more than the percentage of patients needing services. A CQMS isn't a registry, it's a whole lot more. You'll be hearing more from us on this. Stay tuned! Don Nease, MD Cielo MedSolutions' Chief Medical Officer