Eyeworld

EW NEWS & OPINION April 2017 27 registry has been so successful that all the other professions—and I mean all the other professions in medicine—know about it, the Centers for Medicare and Medicaid Services knows about it, members of Congress know about it, and the rapid uptake by the profession really reflects extraordinarily well on us as ophthalmologists," Dr. Parke said. Taking AAO's lead, Dr. Parke said other specialties are now using the same software vendor and pro- cesses as IRIS to develop their own systems. Dr. Parke went on to mention that he serves as chair of a registry coalition for the Council of Medi- cal Specialty Societies (he also just finished a year as president of this organization), which is looking into the applicability of relevant data be- tween specialties. Dr. Parke also said the registry will someday expand to include international data as well. Still a "teenager," so to speak, Dr. Parke said IRIS holds tremendous room for improvement yet. "I feel very confident that when we look at the IRIS registry 3 years from now, we'll look back on the way it is right now and say, 'That was pretty rough and preliminary.' We have a com- mitment to continue to improve IRIS. It's not easy and it's certainly not inexpensive; the Academy has sunk over $10 million into the development of IRIS so far. But we think it's critical to the membership, to the profession, and to patient care, and may be one of the most important things we've ever done. We believe we've just scratched the surface of its potential." EW References 1. Coleman AL. How big data informs us about cataract surgery: The LXXII Edward Jackson Memorial Lecture. Am J Ophthalmol. 2015;160:1091–1103. 2. Willis JR, et al. The prevalence of myopic choroidal neovascularization in the United States: Analysis of the IRIS data registry and NHANES. Ophthalmology. 2016;123:1771–82. Editors' note: Dr. Parke has no finan- cial interests related to his comments. Contact information Parke: dparke@aao.org In fact, there have already been published reports based on analysis of data from IRIS. Anne Coleman, MD, using data from the registry, published a paper in the American Journal of Ophthalmology, which served to "characterize the role of Big Data in evaluating quality of care in ophthalmology." 1 Dr. Coleman concluded that big data from Medicare claims and the IRIS Registry "can help identify addition- al areas for quality improvement… The ability to track patient outcomes in Big Data sets provides opportu- nities for further research on rare complications such as postoperative endophthalmitis and outcomes from uncommon procedures such as cata- ract surgery combined with anterior vitrectomy." Data from IRIS also has been used to determine the preva- lence of high myopia in U.S. adults, progressive high myopia, and myo- pic choroidal neovascularization. 2 The Centers for Disease Control and Prevention (CDC) took note of the registry as well, using it as a national infectious disease surveil- lance tool. Dr. Parke said because data is uploaded every night, certain outbreaks can be detected and, depending on the type, could merit involvement from the CDC. Dr. Parke said the registry is also used to develop new metrics that are truly clinically relevant versus the ones developed by the government for the quality part of physician payment. What's more, the registry is also a means of helping physi- cians with compliance and payment process of Merit-Based Incentive Payment System, or MIPS. "Here is an opportunity for something that is currently zero cost, effectively zero hassle that we have proven has a 100% success rate—we haven't had a single fail- ure—and has already netted oph- thalmologists over $100 million in avoiding penalties and qualifying for bonuses," Dr. Parke said. Other medical specialties and governing bodies have taken note of the various benefits the IRIS Registry has already provided its users and the overall profession. "This is really showcasing the profession of ophthalmology. The

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