A public-private strategy to advance the use of clinical registries.

W ITH an increasing U.S. focus on quality and cost, and the steady maturation of health information technologies, the opportunity to leverage electronic clinical registries to improve outcomes and appropriate utilization of care has never been greater. Two laws passed by the administration of United States President Barack Obama and the United States Congress—the Health Information Technology for Economic and Clinical Health (HITECH) Act provisions of the Recovery Act and the Affordable Care Act—create a new environment in which the use of registries may grow dramatically. This article focuses on the opportunities presented by electronic clinical registries and describes a path through which use of clinical registries may grow. The challenge for the United States government, purchasers, payers, and patients is to create an ecosystem in which clinicians are rewarded for participation in registries; participation is easy and inexpensive and registries provide consistent clinical value to participating clinicians. Meeting these challenges would produce a sustainable clinical and business case for registries—and help address the collective action problem that has so far limited their use.