APA Approves Development of Registry, Takes Other Major Actions
APA’s Board of Trustees tackles an issue-laden agenda at its March meeting.
Health care reform—especially the development of a clinical database to track outcomes—telepsychiatry, and expansion of APA continuing medical education accreditation were among the issues addressed by APA’s Board of Trustees at its meeting last month in Arlington, Va.
APA President Renée Binder, M.D., leads a discussion about whether APA should continue to produce videotaped messages from APA candidates and make them available to members on APA’s website. Trustees voted to do so for one more year and then reevaluate their decision on the basis of detailed usage metrics.
David Hathcox
Importantly, APA Trustees voted to proceed with the development and implementation of a mental health clinical data registry, with the Board receiving detailed updates at each of its regularly scheduled meetings.
The Board’s vote on the registry is another step toward creation of a database that will help psychiatrists conveniently meet the growing requirements to track quality and outcomes of their patients with mental illnesses. The initial recommendation to create a mental health registry came from a Registry Work Group report to the Board in July 2015. The Board also heard about the benefits of a registry for membership from multiple medical associations that had established registries. As a result of these discussions, the Board directed the APA administration to develop a business case for a registry and then a business plan.
Initially, the registry will help psychiatrists meet the growing quality-reporting requirements for insurance payments and board certification. Over time, a registry can also allow for the collection of uniform, clinically rich data including risk factors, treatments, and outcomes at key points for a particular disease or procedure (see sidebar). These data could be used in future research to develop new diagnostics, therapeutics, and quality measures that capture the value of psychiatric care. Registries are increasingly viewed as vital to the goals of the so-called Triple Aim: improving the patient experience of care (including quality and satisfaction), reducing the per capita cost of health care, and improving the health of populations.
Resident-Fellow Member Trustee-elect Stella Cai, M.D., notes that younger members need new ways to become informed about the candidates running in APA’s election.
David Hathcox
“Our Board of Trustees is continuing to move judiciously toward the development of a registry,” said APA President Renée Binder, M.D. “An APA registry has the potential to be enormously useful to members and our profession by giving us data that will demonstrate value-based care, while allowing us to know what works and what doesn’t work in helping our patients achieve recovery.
“The Board took an initial step toward ensuring that we use our resources in the wisest possible way in the pursuit of this endeavor, which is likely to be costly. The Board of Trustees and the APA administration will continue to keep members apprised at every step as we work toward the development of a registry.”
Other Actions
In other business, the Board approved the establishment of the Committee on Telepsychiatry under the Council on Healthcare Systems and Financing to continue the work of the Board’s ad hoc work group on telepsychiatry. The committee will be charged with advising APA on policy, legislative, and regulatory initiatives; developing educational tools for members on telepsychiatry; and creating resource documents for members on the use of telepsychiatry.
What Is a Clinical Data Registry?
Clinical data registries serve as a way to help physicians monitor and report on their patients’ progress. Registries are being developed by medical specialty organizations to help physicians comply with requirements for quality reporting and avoid financial penalties up to 9 percent, as well as to submit Performance-in-Practice data to obtain MOC Part IV credit.
In a registry, physicians report information about a patients’ condition, treatments, and the progress they are making. Patients can also participate by reporting on how they feel. The data from both physicians and patients is carefully protected and includes only unidentifiable data within the registry. The anonymous data, often transferred from an EHR, can also be used for research to identify better treatment options and develop new quality measures.
Medical specialty organizations have established 123 registries. The AMA’s recent National Quality Reporting Network survey found that nearly all medical specialties have developed or are developing registries. In addition, registries have also been established by large health systems and systems using a collaborative care approach.
APA members who have questions or comments about the development of the mental health clinical data registry are invited to send them to [email protected].
The work group’s chair, Jay Shore, M.D., also recommended to the Board that “APA should take a leadership role in advocating for and educating about telepsychiatry at the national and state levels to improve access to care.” The group also said that APA should consider the following policy issues, among others, for further discussion: developing model state legislation around telepsychiatry, introducing legislation around parity reimbursement for telemedicine services, collaborating with the American Telemedicine Association on a joint telepsychiatry guideline, and collaborating with the American Association of Directors of Psychiatric Residency Training on providing educational materials on telepsychiatry for residency training programs.
Additionally, Trustees approved a 12-month pilot expansion of the Joint Sponsorship Program to grant CME accreditation of up to 20 online programs, up to 10 affiliate programs, and up to five outside programs approved by the Council on Medical Education and Lifelong Learning.
In comments to Psychiatric News, Richard Summers, M.D., chair of the APA Council on Medical Education and Lifelong Learning, said the Joint Sponsorship Program will allow APA to grant CME for real-time activities. These include online CME activities put on by district branches and affiliated organizations, which are of increasing interest to APA members, he said.
“Because APA will be able to use existing APA resources, we can charge lower fees than alternative CME-granting entities, and this will allow district branches and affiliated organizations to provide CME less expensively,” Summers said.
Trustees also took up several items related to the APA election. They voted to approve the Videotaping Candidates Interviews Project for one more year. Through this project, candidates for national APA office in the 2016 election were able to make an online campaign address to APA members via videotape. The videotapes were shot by a professional company to ensure consistent quality. For next year’s project, the administration was directed to collect detailed usage metrics and other feedback so that an informed decision can be made regarding further continuation.
APA Secretary Altha Stewart, M.D., says that the Stepping Up Summit, to be held this month in Washington, D.C., will help participating county officials reduce the incarceration of people with mental illness and achieve meaningful mental health reform. The APA Foundation is one of the sponsors.
David Hathcox
The Board also discussed the issue of whether candidates for office should be given the opportunity to distribute several emails to APA members through APA-maintained listservs so that members can learn more about the candidates. After a lengthy discussion, the Board voted to refer the action to a new work group and have the work group report back to the Board at a future meeting.
Finally, the Board approved the appointment of a new editor for the journal Psychiatric Services: Lisa Dixon, M.D., M.P.H., a professor of psychiatry at the Columbia University Medical Center and the director of the Division of Behavioral Health Services and Policy Research. She will move into the position in January 2017, when Howard Goldman, M.D., steps down. Trustees also approved the appointment of Laura Roberts, M.D., as editor in chief of books. Roberts is chair of psychiatry at Stanford University and will replace Robert Hales, M.D., when he steps down in June. ■
APA members can access archived summaries of Board actions at http://psychiatry.org/about-apa/meet-our-organization/governance-meetings/governance-meeting-archives.
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Published online: 8 April 2016
Published in print: April 2, 2016 – April 15, 2016
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