New Quality Measures Aim to Address Gaps & Inequities in Lupus Care

Systemic lupus erythematosus (SLE) is a complex disease for clinicians and their patients, made even more challenging by health disparities that leave some patients with poorer outcomes. Since 2020, the ACR has been leading a project to reduce inequities in symptom recognition, care and disease management of SLE. The project is funded through a five-year grant from the Centers for Disease Control and Prevention (CDC).

One goal of the project is to develop and implement quality measures for patients diagnosed with lupus. This includes developing electronic health record (EHR) tools and utilizing the ACR’s Rheumatology Informatics System for Effectiveness (RISE) registry to provide the data most useful to both rheumatologists who care for patients with lupus and researchers conducting SLE studies.¹

Dr. Bartels

Toward this end, the ACR formed two work groups to identify and address measure gaps. One is focused on longitudinal quality measures and is led by project co-lead Christie Bartels, MD, MS, division chief of rheumatology and associate professor of rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, who is working with April Jorge, MD, assistant professor of medicine, Harvard Medical School, Boston, and director of the lupus program in the Division of Rheumatology, Allergy & Immunology at Massachusetts General Hospital, Boston. The second work group is focused on patient-reported outcome (PRO) measures and is led by project co-lead Jinoos Yazdany, MD, MPH, professor of rheumatology, Department of Medicine, University of California San Francisco (UCSF), and chief of rheumatology at San Francisco General Hospital, who is working with Patricia Katz, PhD, professor emerita of medicine and health policy, UCSF.

Dr. Yazdany

Now in the fourth year of the grant, the work groups have already had significant achievements. They have identified three across-the-board quality measures and two standardized PRO measures to evaluate quality of care for all patients and generated straightforward patient screening and EHR tools to gather patient data uniformly. They are now integrating those measures into the RISE registry to permit national benchmarking of lupus care (see table).²

“There are many things that we can do to improve the quality of care for people with SLE, because we know there are gaps in care, and we know there are a lot of health disparities in this disease,” Dr. Yazdany says. “What we have done is come up with five measures that provide a road map for what we want the future of SLE care to look like.”