Objective: The Rheumatology Informatics System for Effectiveness (RISE) is a national electronic health record (EHR)–enabled registry. RISE passively collects data from EHRs of participating practices, provides advanced quality measurement and data analytic capacities, and fulfills national quality reporting requirements. Here we report the registry's architecture and initial data, and we demonstrate how RISE is being used to improve the quality of care. Methods: RISE is a certified Centers for Medicare and Medicaid Services Qualified Clinical Data Registry, allowing collection of data without individual patient informed consent. We analyzed data between October 1, 2014 and September 30, 2015 to characterize initial practices and patients captured in RISE. We also analyzed medication use among rheumatoid arthritis (RA) patients and performance on several quality measures. Results: Across 55 sites, 312 clinicians contributed data to RISE; 72% were in group practice, 21% in solo practice, and 7% were part of a larger health system. Sites contributed data on 239,302 individuals. Among the subset with RA, 34.4% of patients were taking a biologic or targeted synthetic disease-modifying antirheumatic drug (DMARD) at their last encounter, and 66.7% were receiving a nonbiologic DMARD. Examples of quality measures include that 55.2% had a disease activity score recorded, 53.6% a functional status score, and 91.0% were taking a DMARD in the last year. Conclusion: RISE provides critical infrastructure for improving the quality of care in rheumatology and is a unique data source to generate new knowledge. Data validation and mapping are ongoing and RISE is available to the research and clinical communities to advance rheumatology.

Takayasu arteritis (TA) is a systemic chronic inflammatory large-vessel vasculitis that affects the aorta, its major branches, and the pulmonary arteries. In this report, we describe a case of a young female with TA presenting with spontaneous subarachnoid hemorrhage (SAH), an unusual manifestation of the disease. Magnetic resonance angiography (MRA) of the head and neck demonstrates multifocal carotid and vertebral arterial stenoses, but no aneurysm or vascular malformation to account for SAH. A novel and unexpected finding in this case was increased cerebral perfusion in the right frontotemporal parenchyma and transient abnormally reduced augmentation of flow in response to the cerebral vasodilator acetazolamide. The etiology of SAH thus may be related to hyperperfusion and loss of cerebrovascular autoregulation leading to small vessel damage.

Residency education has been disrupted by the coronavirus disease 2019 (COVID‐19) pandemic. Programs in pandemic status, as designated by the "Accreditation Council for Graduate Medical Education (ACGME) in the US, have substantially modified or suspended traditional educational activities to adhere to physical distancing practices and allow residents to focus on patient care. This lapse in educational events is especially challenging now, as residents and other healthcare professionals are facing a previously undocumented illness and must stay current with the deluge of new information on the disease. Hence, there is a need for simple, digestible, up‐to‐date, and accurate information on COVID‐19 that is electronically disseminated and easy to obtain.