Developing a CKD registry in primary care: provider attitudes and input.

Area of Science:

• Health Services Research
• Primary Care Medicine
• Chronic Disease Management

Background:

• Chronic disease registries effectively improve care for diabetes and hypertension.
• Registries have not shown similar success for chronic kidney disease (CKD) management.
• Understanding primary care provider perspectives is crucial for developing effective CKD registries.

Purpose of the Study:

• To explore primary care provider attitudes towards a CKD registry.
• To identify facilitators for implementing a CKD registry in safety-net primary care.
• To compare potential benefits of a CKD registry with those for other chronic diseases.

Main Methods:

• Qualitative study utilizing semistructured interviews.
• Interviews conducted with medical directors and quality improvement champions in San Francisco safety-net clinics.
• Grounded theory approach used for transcription and analysis until thematic saturation.

Main Results:

• Four themes emerged regarding CKD registry development: provider belief in team-based care benefits, importance of workflow and staffing, complexities of CKD potentially limiting non-physician use, and alignment with current primary care priorities.
• 20 primary care providers were interviewed.
• Successful implementation hinges on workflow redesign and staffing.

Conclusions:

• A CKD registry can enhance care coordination and standardization for the entire health care team.
• Decision support functionality within a CKD registry is key to improving management in safety-net settings.
• Findings informed the development of a CKD registry in San Francisco safety-net primary care.