FEB 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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E W NEWS & OPINION 1 3 The IRIS Registry will be the nation's first EHR- based comprehensive eye disease database T he Intelligent Research in Sight (IRIS) Registry will be the nation's first compre- hensive eye disease and condition patient database, according to the American Academy o f Ophthalmology (AAO, San Fran- cisco), which debuted the program during its annual meeting this past November. While a registry is basically a quality improvement activity de- signed to produce better outcomes and satisfy the regulatory needs of a profession, the IRIS is "built on the longitudinal ability to follow pa- tients," said William L. Rich III, MD, medical director of health policy, and chair of the Registry Measure Development Work Group, AAO, during a press conference. "We can now overlay the interventions in treatment across all ophthalmic diseases. It's really a game-changer." Noting that improving out- comes is "part of [ophthalmologists'] culture," Dr. Rich said the specialty took part in the first clinical trial in 1950, and the desire to continually improve outcomes hasn't waned since. "Now the technology is there, the desire is there—it's part of our culture. This is the largest financial commitment and outlay since the Academy's inception," he said. The IRIS Registry is expected to provide streamlined participation in the Centers for Medicare and Medicaid Services' (CMS) Physician Quality Reporting System (PQRS), AAO said. How it works The IRIS Registry is a centralized col- lection and reporting software tool that compiles and processes data from electronic health records (EHR) to enable ophthalmologists to statistically analyze their own care, compare it to that of their peers, and pinpoint opportunities for improvement, according to AAO. "The database also allows oph- thalmologists to manage their pa- tients at a population level; study a specific group of patients based on conditions, risk factors, demograph- ics or outcomes; identify trends and t rack interventions and answer specific clinical questions," AAO said in a news release. The IRIS Registry is currently being piloted with 120 ophthalmol- ogy practices, representing approxi- mately 370,000 patient encounters across 35 states. The Academy esti- mates that the database will be pop- u lated with data from more than 18 million patient encounters by 2016, "based on an assumption that each ophthalmologist sees 7,000–8,000 patient encounters a year," said Michael F. Chiang, MD, chair of AAO's Medical Information Technol- ogy Committee, and Knowles Professor of Ophthalmology & Medical Informatics, Oregon Health & Science University, Portland. IRIS allows ophthalmologists to follow someone with a disease to a procedure, back from the procedure, and then continue forward. "These are clinical data," said David May, MD, president of the Texas Chapter of the American Col- lege of Cardiology (ACC), and mem- ber of the ACC PINNACLE Registry Steering Committee. "They capture the clinical features of the patient monitored over time." What about cost? Access to the IRIS Registry will be made widely available to U.S.-based members of the Academy by April 2014, with the first 2,000 U.S.-based Academy members who sign up to participate receiving it at no cost for the first two years. With an estimated 18 million patient encounters captured by IRIS by 2016, "we'll have an enormous database to look at new drugs and their impact," Dr. Rich said. The cost to join the registry has not yet been publicized, but the database is expected to save a practice money as well, AAO said. As practices try to comply with the mandated quality improvement programs initiated during the Bush Administration, "the government found penalties are more effective than bonuses," Dr. Rich said. "A 5% cut in your fees has a far greater impact or profit than a 5% bonus might have." Practices that do not comply will have penalties up to 5% im- posed by 2016, Dr. Rich said. "These a re ongoing penalties. After two years, it makes a practice unsustain- able." As an approved PQRS electronic health record submission vendor, the IRIS Registry can directly and automatically extract data for PQRS measures and submit it to CMS on a practice's behalf, Dr. Rich added. Current status As of the 2013 AAO meeting, there w ere 124 practices across the coun- try, 685 providers at 332 locations reporting 370,000 patient encoun- ters, Dr. Chiang said. "So this is not theoretical data— it's real numbers," he said. The IRIS Registry has been designed to work with any EHR, and there are 11 large EHR vendors that have already been mapped to the Registry, Dr. Chiang said. A full rollout is expected on March 25, he added. The IRIS Registry is envisioned to support the A merican Board of Ophthalmology's Maintenance of Certification Part IV Practice Improvement Modules by automating the collection of data directly from EHRs, Dr. Chiang said. The Registry also has subspecialty outcomes measures—cataract, glau- coma, retina, pediatrics, etc. ASCRS was involved in the development of t he cataract template used in the registry. For more information, visit aao.org/irisregistry. EW Editors' note: The physicians have no financial interests related to this article. Contact information Rich: hyasxa@gmail.com Chiang: chiangm@ohsu.edu May: dmay@cvscardio.com by Michelle Dalton EyeWorld Contributing Writer AAO launches ambitious patient registry February 2014 Save The Date! SAN DIEGO 2015 www.corneacongress.org Sponsored by the Cornea Society APRIL 15-17, 2015 13-25 News_EW February 2014-DL2-ALT-OIS-ad_Layout 1 1/30/14 10:06 AM Page 13

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