Can you give me a technical overview of the electronic health record (EHR) system integration process for the IRISTM Registry?
The EHR system integration for the IRISTM Registry involves the installation of a piece of interface software known as the AAO Light Weight Connector. This software is installed on a server in your practice and helps us interface with your EHR in order to extract IRISTM Registry data fields for reporting to the Academy.
The software has three main pieces. First: a Microsoft SQL-based database that stores all the information related to the IRISTM Registry (the measures and the data maps specific to your EHR). Second: a .NET 3.5-based Windows Service that is the actual program that interfaces with your EHR and extracts the relevant ophthalmology registry data. Third: a .NET 3.5-based Windows Client that is the program that is used to configure the data extraction tasks and adjust mappings to suit your practice's specific use of your EHR.
Does the system integration software program write any information into our EHR?
No, the program is strictly read-only. At no point does the program write anything in your EHR system. A read-only user has very specific read-only rights to a database and its tables and is technically incapable of changing or corrupting your data.
How much data does the system integration software program extract from our EHR?
We only extract the information required for the IRISTM Registry reporting. A complete list of the fields that are extracted is located in the IRISTM Registry Data Dictionary. You can request a copy of the data dictionary by sending an email to firstname.lastname@example.org.
How often do you collect and transmit data into the IRISTM Registry?
The IRISTM Registry data is collected once you finalize and complete your encounters and documentations. We will schedule a daily or weekly batching and transmission process that will connect securely to the Academy's servers. This can be scheduled at your convenience, during non-office hours or the weekends, so that the process won't interfere with any clinical activities. There should be no interference with the performance of your server.
How much space does the system integration software program require on my server?
The IRISTM Registry requires reporting of all data elements on every doctor-patient visit that meets the inclusion criteria. Because the extracted data is transmitted to the Academy on a regular basis, the storage space on your server is minimal. However, it is recommended that you allocate at least 1 GB of disc space on your server for this project.
How much memory is used by the system integration software program?
We have observed that memory consumption by the system integration program varies between 250 MB to 700 MB; therefore, we recommend having at least 2 GB of memory available on your server.
How do you transmit my data to your servers?
We utilize industry-recognized Secure File Transfer Protocol (SFTP) to transmit the IRISTM Registry data to Academy servers. Health Insurance Portability and Accountability Act (HIPAA) compliance for both privacy and security is ensured throughout the process.
How much does our staff get involved in installing and running the system integration software program? Do I need to allocate a substantial amount of time/resources to participate in the system integration program?
Installation of the system integration software program is fairly quick. However, we will need some help from your EHR expert staff for the initial mapping process. The mapping discussions normally take two to four weeks – depending on the complexity of customization of your EHR as well as the amount of time your staff can allocate each week to the process. In general, your staff allocation time should be around two to four hours per week during the initial mapping process phase. While we try to handle most of the discussions via email, it may be necessary for your team to participate in a few GoToMeeting online web conference sessions to finalize the mapping process properly. Our technical experts take it from here. We'll take care of all the configuration and ongoing maintenance that needs to be done to successfully extract the IRISTM Registry data from your EHR and export it in the required format to the Academy. Below is a list of tasks we anticipate your staff will need to be involved in:
||Estimated Maximum Time
||Review the Fact Sheet & FAQ; Review and complete the Technical Questionnaire.
||Review and complete the Pre-Install Check List.
||Download and install .NET 3.5 frame work (if necessary).
||Attend a GoToMeeting online web conference to view a system integration solution install.
||Answer questions about locations and data mapping.
||Minimum of 3 GotoMeeting sessions
||If you have a “home grown” EHR system or a heavily customized EHR, you may need to answer specific data mapping questions in a GoToMeeting online web conference (if necessary).
||One additional GoToMeeting session
How can I get support for the system integration software program after it's installed?
You can send an email to email@example.com. We’re committed to providing you a prompt response.
Will participating in the IRISTM Registry allow me to participate in the Physician Quality Reporting System (PQRS) incentive program?
The IRISTM Registry is qualified to submit data on behalf of physicians for the PQRS. If your practice has the system integration software program installed, the Academy should be able to collect the required PQRS data elements automatically. You do not need to submit any separate data files, though you will need to sign an additional Data Release Consent Form (DRCF).
Which requirement of the federal EHR Incentive Program could be met by the use of the IRISTM Registry?
The IRISTM Registry will partially satisfy the EHR Incentive Program's menu set for Stage 2 of the program, of which physicians must complete at least three out of six possible objectives. Specifically, this particular measure requires successful ongoing transmission of specific case report information to a specialized registry. The requirement here is that the information must be reported from the eligible professional's certified EHR (not the hospital's EHR) directly to a registry. The IRISTM Registry gathers information directly from EHRs, thus enabling participating physicians to meet this requirement.
Physicians who participate in electronic reporting for PQRS through the IRISTM Registry also satisfy the clinical quality measure requirement for meaningful use.
What EHR systems have you successfully integrated with the IRISTM Registry?
Below is the current list of systems with the system integration software in place at one or more practices. If your EHR is not listed here, it just means we have not yet worked with a practice with your system. Chances are good that we can still install the software by mapping the data collected in your EHR system to the IRISTM Registry data elements. The system integration software program is designed to work with any EHR system. To find out about your specific EHR, contact us at firstname.lastname@example.org.
Data elements have been successfully mapped from these EHRs:
- EyeDoc EMR
- EyeMD EMR
- GE Centricity EMR
- IO Practiceware
- MaximEye EHR
- Vitera Intergy EHR
- WebChart EHR
Where does the data from the EHR come from?
Some data comes from existing lists in the EHR (e.g., problem lists, medications, procedure, demographics), and some data comes from individual encounters (e.g., vital signs, visual acuity, exam findings, PMH/POH, diagnoses). All of these data are updated at every encounter. Most of these data elements are collected as structured data (this is ideal). There is no natural language processing being used or planned for the immediate future. Because different EHRs store data using different terminologies (e.g., ICD9, ICD10, SNOMED, proprietary terminologies, free text), the "term" as well as the underlying "terminology" are stored.
Ultimately, the IRISTM Registry database organizes the information into a Clinical Document Architecture (CDA) structure for each patient. This includes elements that are characteristics of the patient (e.g., date of birth, past surgeries), as well as elements that are characteristics of individual exams (e.g., visual acuity).
Is my data submitted to the registry able to be subpoenaed by a plaintiff's attorney?
It is highly unlikely that registry data would be used in a case against a physician. Professional liability cases center on whether the defendant physician’s treatment of the plaintiff patient was consistent with the relevant standard of care. That is determined by looking at how an ordinary and prudent ophthalmologist in the same area would have performed when faced with a similarly situated patient (i.e., with a patient presenting with similar circumstances, including risk factors. While registry data can help determine which treatments lead to the best outcomes, it will not be the principal factor in establishing a standard of care or determining whether the standard of care was met in a particular case. From a practical perspective, none of the other longstanding medical society data registries has ever received a subpoena for member data, aggregate data or reports/analyses. In addition, many states have laws that protect data used for quality improvement. This does not mean that a subpoena could not be issued to the Academy for IRIS™ Registry data, but, practically speaking, it is not likely to happen.
More questions? Contact us
Send an email to email@example.com for support.