Mental Health Registry Home
Frequently Asked Questions
Learn about the development and benefits of a mental health registry as well as find answers to questions about accessing and using data, security and privacy, cost and requirements, and how to enroll.
What is a clinical registry?
A clinical registry is an organized system that collects data (reported by patients and providers) which are then used to better understand patients’ health care history and experiences, as well as the quality of care they are being provided. With the increasing usage of electronic health records (EHR), registries have emerged as a valuable method of using the latest information technology to capture data that will aid psychiatrists in making decisions about the most optimal patient care. Such registries are already being successfully used within other medical specialties and medical associations, including the American Academy of Neurology, American College of Cardiology, American Society of Clinical Oncology and many others.
Why is the APA developing a registry, and how will it benefit psychiatrists?
APA is committed to helping psychiatrists meet new Medicare quality reporting requirements and maintain professional recertification—all in a way that avoids significant administrative burdens. Specifically, this registry will help members avoid payment penalties associated with failure to meet quality reporting requirements set by the Centers for Medicare & Medicaid Services (CMS) and by the future Merit-Based Incentive Payment System. These payment penalties will increase progressively each year from 2019 to 2022 from 4% to 9%. A registry will give psychiatrists an easy and effective way to transmit quality reporting data to CMS and help them avoid these penalties.
A registry also gives psychiatrists a simple method of submitting Performance-in-Practice data and obtaining ABPN Maintenance of Certification (MOC) Part IV credit. Maintenance of Certification is critical to maintaining board certification and hospital credentialing. The registry’s software will generate automated reports and transmit them electronically to easily fulfill MOC Part IV.
Finally, the APA is developing this registry to help decrease routine administrative reporting burdens by consolidating and simplifying the production and submission process for the various regulatory and administrative demands faced by psychiatrists. This includes generating patient and progress reports, which help busy psychiatrists track patients’ outcomes and provide clinical decision-support tools to inform evidence-based care.
How does the APA registry work?
Pertinent data will be extracted automatically from the EHR and transmitted on a scheduled basis directly to the APA registry. Participating psychiatrists can then access the data in the form of calculated quality measures that will help them examine their own patient population and benchmark practice performance to uncover potential areas for quality improvement. Quality measure results can also be compared to higher levels of aggregated data to answer questions, such as: "How are my patients with Major Depressive Disorder doing compared to patients with depression in the city, region, state, or nationally?"
Is the APA mental health registry currently in full operation?
No, we are in the process of developing the registry. Development of the registry involves 3 phases:
- Proof of Concept (POC) testing (60 days);
- Pilot cohort testing (90 days); and
- Full-scale launch
We are currently in the POC phase, where we are inviting practicing psychiatrists with an EHR system in place to test the basic set up of the registry and linkages.
What data would I have access to as an APA registry participant?
The APA registry allows you to view run quality reports that provide clinician-, practice- and national-level results for all measures. Participants have access to their own performance metrics. In addition, the registry participants can use the registry to compare their performance and outcomes to similar practices at the regional and national level. It is also possible to make comparisons over time within a physician’s own practice.
Is it necessary to have an EHR system to participate in the APA registry?
Initially, we will need participants using an EHR regardless of the setting in which they work (i.e., in solo or group practices or academic settings or larger systems of care). Eventually, we plan to be able to accommodate physicians who do not use an EHR to either 1) enter through a web-based portal, or 2) be able to accept scanned paper and pencil information into the registry.
Can the registry data be used for the Merit-Based Incentive Payment System reporting?
Yes, the APA is taking steps to become a Qualified Clinical Data Registry in 2017.
What are the quality measures included in the registry?
The APA is currently working with FIGmd the registry developer, to implement 25 Merit-based Incentive Payment System (MIPS) measures. These measures have been chosen to provide registry participants with a broad group of measures from which to pick and report on those that best reflect their process of care and the patient population served. The current list of 25 quality measures encompasses both adult and child populations and well as hospital and outpatient settings.
Security and Privacy
How does the registry handle patient information and other confidential data?
Practices that join the APA registry enter into an agreement with the APA, which includes a HIPAA-compliant Business Associate Agreement. Protected Health Information and identifiable provider information will be captured and stored by the APA registry in accordance with federal and state laws and regulations.
The APA registry will not publish any identifiable provider or practice data without permission. The registry will not have direct access to a patient’s Protected Health Information (PHI) but rather to a limited set of de-identified data that correspond to the actual PHI. Only the provider’s home institution or practice will have access to the PHI data, which they can use for their own needs and for quality reporting to CMS. To ensure confidentiality of patient information, data in the registry will be stored separately, in compliance with federal and state laws.
Who will have access to my data?
No one will have access to your data without your written permission. The process will be similar to that for data submission to CMS for PQRS in that each provider must sign a Data Release Consent Form allowing the registry to submit your data on your behalf. The APA registry collects, stores and reports data on a psychiatrist’s behalf, taking every measure possible to safeguard it. The APA’s technology partner, FIGmd, is compliant with all local and federal regulations governing these areas, including HIPAA provisions and the recently updated provisions as part of the American Recovery and Reinvestment Act/Health Information Technology for Economic and Clinical Health Act.
How will the APA use the data in the registry?
Based on the limited data set in the registry, the APA will be able to publish benchmarks that can be used to assess psychiatrists’ outcomes, practice patterns and utilization of new technology to look at overall trends in outcomes for the patient population. Mental health registry data will also allow the APA to better focus its educational programming and service offerings for members.
Cost and Requirements of Participation
What are the costs for participating in the APA Registry?
There will be no cost for those participating in the proof of concept, pilot testing and initial scaling phases of the registry. These phases began in July 2016 and we anticipate they will conclude on Dec. 31, 2017. After this time, the value of the registry may be fully realized by capturing bonuses, fulfilling MOC part IV, and being able to better measure quality of care. APA members will continue to enjoy these benefits at no cost. To make it self-sustainable, non-members will be asked to pay a fee that will be determined based on what other specialty registries are doing at the time. For successful research grants, participants in the APA Registry and their institutions would be provided with data access at a reduced cost.
What are the time commitments for my office staff?
The APA registry will be easy to use, timely and responsive to the needs of the profession. It is designed to require minimal input and data entry from your staff. Using an EHR, you or a staff person can expect to spend an average of 1 hour per week for about 3 weeks to assist in the installation. Following installation, there is no additional work required unless the practice's EHR software is updated.
How do I get started?
What are the initial steps for me or my site to participate or join the registry?
To initiate participation in the registry, the psychiatrist or designated person at the site will need to sign two agreements with APA: (a) Participation Agreement and (b) Business Associate and Data Use agreement that do the following:
- Permits APA to download the software to establish a VPN connection;
- Represents that patients have given appropriate permissions for their data to be used for quality reporting purposes and research using de-identified data;
- Addresses data safety, privacy, security, and insurance issues to protect all parties;
- Identifies appropriate uses of the data; and
- Generally, outlines the parties’ expectations and obligations
Is Institutional Review Board (IRB) approval needed for participation in the registry?
The IRB approval that the APA will obtain will be extended to participating psychiatrists. If a psychiatrist is covered by another IRB, APA will assist to obtain that IRB’s approval.
Can I join the registry and leave the registry at any time?
Yes, members may terminate or begin their participation in the registry at any time. Timing of beginning of participation is governed by the numbers of people interested at any given time.
As an international psychiatrist, can I participate?
To ensure the APA registry infrastructure is properly developed with features and functionalities that meet the needs of psychiatrists, the APA registry is currently only open to psychiatrists practicing in the U.S. and its territories. In the future, the APA will examine the possibility of expanding the APA registry to include international participants.
Do all physicians in a practice need to participate in the APA registry?
It is not required that all physicians within a practice participate in the registry. However, participation by all physicians in a practice is strongly encouraged to generate data that most accurately reflects practice performance.
How can the APA registry be used for research?
Individual institutions will eventually be able to access their own data via secure dashboards for their own internal benchmarking. The APA will apply to the APA Institutional Review Board for approval to make de-identified data available for future research purposes. In addition, informed consent will be obtained from psychiatrists and patients to potentially be recontacted if they are eligible for specific studies. The APA will establish an oversight group to set APA registry research and publication policies and procedures.