J. Timothy (Tim) Harrington, MD, a rheumatologist at UW Health, the academic health system for the University of Wisconsin in Madison, became interested in CORRONA “because of the ability to create a ‘laboratory’ for testing standardized data management and its impacts on care and disease outcomes,” he says. His collaborations with Dr. Kremer had their start in 2000 with a discussion during a continuing medical education course in Whistler, B.C. “We shared our dreams,” Dr. Harrington recalls. “His was to build an RA observational registry, which has become CORRONA, and mine was to improve and redesign rheumatology practice in the United States—both rather humble goals,” he quips.
Since that time, Dr. Harrington, a noted quality-improvement researcher and author, has become chief site quality officer for CORRONA. In that capacity, he has overseen refinement of the data questionnaire and incorporation of several practice efficiency elements, such as the Physician Quality and Reporting System and Meaningful Use, into the CORRONA registry for participating practices. He was also the first to do a pilot study implementing the CORRONA data set, and found that by using its standardized data set, he was able to decrease by 40% the amount of time he spent taking the patient’s history and documenting encounters in the medical record. “I used to spend 70% of my time finding out what’s going on with the patient and 30% doing something about it. Now I spend 30% of my finding out what’s going on and 70% of my time doing something about it!” Dr. Harrington says. This process has implications for dealing with workforce issues as well, he notes. “If you standardize the data process within your practice, then you can start to move major amounts of work for coordinating patient care, assessing disease status, and treatment safety from the physician visit into the nurse or [nurse practitioner] encounter,” he maintained. [For more on practice redesign, read “High-Impact Rheumatology Practice Redesign” at www.The-Rheumatologist.org.]
“The CORRONA Virus”
At the outset, Dr. Kremer says, “I insisted on two themes. One was to work with and empower good people, and the other was to be inclusive. We have a horizontal structure, not a vertical one, and that has allowed an environment of mutual respect.” He rejoices about the high level of talent the database has attracted. The company now has a staff of 35 employees, including Chief Operating Officer James Cavan, MS, crack information-technology and project-management teams, and an experienced epidemiological and biostatistician cadre, as well as legal and other support staff.
