Table 1.

Factors (Conditions), Condition Descriptors, and Qualitative Comparative Analysis Scoring (Calibration) Used to Identify Key Ingredients in Successful Registry Implementation

ConditionDescription of ConditionCalibration
Health systemThe degree to which the practice was part of a large, multi-practice, hospital-owned health system1 = practice is owned by health system, complete control
0 = practice is owned by the physicians or others in the practice
Key personThe degree to which there was a key person who “made things happen” for the registry implementation1 = very clear evidence of a key person; there, willing, and capable to do what was needed
0 = no evidence of a key person or key persons; no one willing to step in and make things happen
QI mindsetThe degree to which the practice displayed a mindset of interest in continually improving quality, looking for opportunity to change and get better1 = Past and ongoing QI mindset evident in multiple practice members; institutionalized or embedded in practice culture
0 = No evidence of QI mindset, often evidence of contrary attitude (resisting change)
EHR capabilityThe extent to which the EHR had the capability to be changed to accommodate development of a registry; includes the extent to which the practice members or others in the system had the skills and knowledge to make these changes1 = EHR with registry features already included or completely able to make any changes needed; including consideration of the system capability and the organization allowing these changes
0 = EHR not modifiable; cannot manipulate at all to meet reporting needs
ResourcesThe tangible items such as funding (to support people or EHR modifications), space, and time to complete necessary actions to get the registry to work1 = sufficient resources to “get the job done,” for example, training or dedicated time provided for on the ground key person to implement or maintain registry
0 = lacking in resources such that a barrier or barriers were created, for example, no training provided when needed, or no time dedicated in already full workload for added tasks
LeadershipUsually at the health system level, but also at the practice level (if independent practice) to initiate and support changes for registry implementation1 = significant organizational leadership role in driving and supporting the change
0 = no organizational leadership role in driving or supporting the change
IncentivesAnticipation of or actual availability of incentives for transformation, such as reimbursement changes or accreditation, as a motivator for PCMH transformation.1 = actual or potential for significant financial incentives as a driver of transformation
0 = no incentives (in place or anticipated) as driver of transformation
OUTCOME: registry implementation “success”Extent to which the practice was able to implement a fully functioning registry within their EHR within the time frame of the QI project1 = Completed full registry and had ability to report data as needed
0 = Completely unable to implement registry or report needed data