New Surveillance Registry Helps VA Provide Consistent Care to MS Patients

By Annette M. Boyle

William J. (“Joel”) Culpepper II, PhD, MA, associate director of Epidemiology and Informatics for the Center of Excellence

WASHINGTON — After several years of development and testing, the VA’s Multiple Sclerosis Surveillance Registry (MSSR) is ready for rollout — and that means veterans are likely to receive more consistent and better coordinated care.

Disease-specific databases such as the MSSR can help in management of neurological conditions, but few are well integrated into patients’ electronic medical records or linked to health systems data, according to leading researchers at the VHA Multiple Sclerosis Center of Excellence-East in Washington.

To address that problem, William J. (“Joel”) Culpepper II, PhD, MA, associate director of Epidemiology and Informatics for the Center of Excellence, and Mitchell T. Wallin, MD, MPH, the center’s interim director, and colleagues have worked to develop and refine the MSSR so it will work seamlessly with the VA’s electronic health record (EHR).

The Multiple Sclerosis Assessment Tool (MSAT) and MSSR provide a “mechanism for the systematic collection of a minimum data set of pertinent MS clinical information that is currently not standardized within the VHA EHR. This provides standardized data collection and enables reporting of MS relevant information at the patient, clinic and national level,” Wallin said.

One of the challenges faced in creating the database was the need to use consistent information technology architecture across the VA’s multiple disease registries. The team built the MSSR in an iterative, cooperative process with IT and MS specialists, they explained in a presentation at the American Academy of Neurology Annual Meeting. 1

The base was a common converged registry solution platform that is also used by the traumatic brain injury and cancer registries. Using the platform “allows relatively easy cross-linkages across the existing and future registries,” Culpepper told U.S. Medicine.

Clinicians can access the data entry portal, the MSAT, via a web link from within the VA’s Computerized Patient Record System (CPRS). Once an assessment is completed, a clinical note is generated and is stored within the EHR for all providers to access,” Wallin said.

The team first tested the system at regional MS clinics within the mid-Atlantic and Pacific Northwest regional networks, initially enrolling 930 veterans between 2013 and 2015. Today, the database includes 1,077 veterans with MS, out of the approximately 25,000 veterans with the disease who actively use the VA healthcare system.

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