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

Dr. Katz

Standardization of screening is important so that “everybody is using the same yardstick,” Dr. Katz says. Data collected in a consistent manner across EHRs and in the RISE registry can allow for rigorous research into not only the effectiveness of different treatments, but also possible disparities in treatments or outcomes, which can then enable building policies to address them.

The work group is now running a small pilot of the depression and physical function screenings, Dr. Katz says. “We have five test practices participating, and we’ll be having conversations soon to see how the screenings are working and whether the practices find the data of value. This is the information we need so we can make adjustments and, eventually, make the bigger effort to roll this out nationally.”

The pilot study will also explore whether rheumatology practices are comfortable conducting the screenings in routine care. For example, Dr. Yazdany says, rheumatologists often feel screening for depression is better relegated to the primary care setting. The patient advisory group, however, was adamant that rheumatologists are better equipped in that arena because they understand the struggles of lupus patients far better than do primary care doctors, who may only care for one lupus patient.

A further step will be to conduct a pilot study to delve into how rheumatologists may use the results of depression assessments. “Do they refer patients back to their family care doctor? Do they deal with a high score on a depression assessment themselves? Do they provide resources to the patients? This is not a trivial thing,” Dr. Yazdany remarks. “We need to figure out what to do with the information, and this is another area where our five pilot practices will help.”

The screenings are vital, Dr. Katz says. “Most of the clinical measures of lupus are really physician facing; these assessments give the patients the opportunity, in a standardized way, to express how they’re doing and bring [their] voice into regular lupus monitoring, [as well as] opens the door to support for depression or physical function, if needed. Beyond that, it also gives the patients tools to monitor themselves over time and, overall, gives them more agency in a clinical setting.”

Once the PRO work group has data from the pilot practices, it also hopes to begin building these measures into the RISE registry. “All of this work will be completed in the next two years, by the end of the grant,” Dr. Yazdany says. “It’s an ambitious project, but a really important one.”