Security and Privacy
Cost and Requirements of Participation
What is the IRIS Registry?
The IRISTM Registry (Intelligent Research in Sight) is the nation's first EHR-based (electronic health record) comprehensive eye disease clinical database. It is a centralized data repository and reporting tool that uses observational study methods to collect and perform statistical analysis of patient data to produce easy-to-interpret, national and inter-practice benchmark reports. The reports can validate the quality of care ophthalmologists provide and pinpoint opportunities for improvement.
As an approved Physician Quality Reporting System (PQRS) electronic health record submission vendor, the IRISTM Registry can directly and automatically extract data for PQRS measures and submit it to CMS on the ophthalmologist's behalf. In the future, the IRISTM registry could also be used for purposes such as supporting the American Board of Ophthalmology's Maintenance of Certification Part IV Practice Improvement Modules by automating the collection of data directly from EHRs, clinical research, post-market surveillance studies, early detection of safety signals and determining changes in practice patterns.
Why should ophthalmologists participate in the IRISTM Registry?
The IRISTM Registry is a valuable tool that will enable ophthalmology practices to:
- Improve Patient Care
Monitor patient interactions, track interventions, identify and address gaps in quality of care, and measure quality outcomes.
- Manage Patient Populations
Proactively manage clinical conditions for entire patient populations by running reports on specific care criteria.
- Benchmark Their Individual Performance and That of Their Practice
Run quality reports on demand, providing clinician- and practice-level results, plus national results and patient-level detail for PQRS measures.
- Enhance Quality and Practice Efficiency
Ophthalmologists can use the IRISTM Registry data to analyze practice processes and procedures and as a source for fact-based decision-making. Because the ophthalmology registry will capture data over time, it will help practices efficiently manage patient care and demonstrate the appropriate use of resources to payors and purchasers.
- Participate in Quality Reporting and Incentive Programs
The IRISTM Registry is a CMS-certified data submission vendor, enabling practices to directly submit EHR data for the CMS Physician Quality Reporting System (PQRS), to earn a Medicare bonus and avoid the PQRS penalty. Participation in the IRIS Registry also satisfies a menu requirement for Stage 2 of the EHR Incentive Program.
- Join a Community of Quality
IRIS Registry users become a member of a like-minded community of quality-driven professionals striving to continuously improve patient care. It enables users to interact with peers to create opportunities for sharing quality improvement strategies and broaden their professional network. Over time, the ophthalmology registry will include elements to help ophthalmologists meet Maintenance of Certification requirements. Aggregate data also will be used by the Academy to identify topics where practice improvement modules are needed.
What is a clinical registry?
A clinical registry is an organized system that collects uniform data (clinical and patient-reported) to evaluate specified outcomes for a population defined by a particular disease. With the increasing usage of EHRs, registries have emerged as valuable solutions for harnessing the power of information technology to capture statistically-relevant, evidence-based data to aid in decisions regarding the most optimal patient care. Such registries are already being successfully used within other medical specialties and medical associations, including the American College of Cardiology and the Society of Thoracic Surgeons.
Why is the Academy providing this technology resource?
The Academy is committed to continually improving and innovating ophthalmic patient care. With the increasing adoption of EHRs and other advances in technology, physicians now have the ability to perform their own data analysis to inform better clinical decision-making. Using disease registries in this manner is the future of medicine, as evidenced by the success of the registries developed by the American College of Cardiology and the Society of Thoracic Surgeons. The timing is right for ophthalmology to be among the early adopters in strategically deploying information technology to drive quality improvement objectives.
Is the IRISTM Registry being developed as part of the Accountable Care Act or other government mandate?
Clinical data registries antedate healthcare reform by two decades. They are not a mandated part of health care reform, nor are they required to comply with any federal regulations. The overarching purpose is to provide ophthalmologists with clinical data that enables them to benchmark their practice's performance and drive improvement in patient outcomes.
Is the Academy capable of delivering a quality information technology solution?
The Academy is partnering in the development of the IRIS Registry with FIGMD, Inc., a company that specializes in integrating EHRs with registries. FIGMD has developed and maintained registries for the American College of Cardiology and has completed integration projects for more than 15 major EHRs and is capable of working quickly with new systems.
How does the IRISTM Registry work?
Data relevant to the registry will be extracted automatically from the office EHR and transmitted on a scheduled basis directly to the IRISTM Registry. Participating ophthalmologists then can access the data and run queries on their own patient population, to benchmark practice performance and uncover potential areas for quality improvement.
Results can also be compared to the larger aggregated data, such as: "What is the return rate to the OR within the first 30 days postop of cataract surgery and how does it compare to the national norm?" This type of research can be done virtually through the IRISTM Registry, without bogging down the practice's own EHR.
How will it affect my practice workflow?
The IRISTM Registry has been designed to minimize your participation overhead and time spent on data entry while immediately delivering valuable tools that your practice can use. Many clinical registries include laborious data entry, confusing technology and little immediate return on effort. The IRISTM Registry avoids these problems.
What data would I have access to as an IRISTM Registry participant?
The IRISTM Registry allows you to run quality reports that provide clinician-, practice- and national-level results for all PQRS measures. Each participant has access to their own performance data. In addition, the registry includes comparative peer groups based on practice characteristics, which participants can use to compare their performance and outcomes to similar practices at the regional and national level. It is also possible to generate comparative analysis within an ophthalmologist's own practice. Users will eventually be able to answer questions, such as:
- What is my exact posterior capsule rupture rate?
- What is my rate of return to the operating room within 60 days after retinal detachment surgery?
- What percentage of my diabetic patients under age 60 develop macular edema following intraocular surgery?
- What percentage of my patients with a diagnosis of glaucoma and early cupping have had a visual field during the past year?
Is it necessary to have an EHR system to participate in the IRISTM Registry?
Although there are mechanisms to input data without using an EHR, the system works best in association with one. The following is a list of EHR systems to which the IRISTM Registry has successfully mapped data elements. However, the IRISTM Registry's system integration software program is designed to work with any EHR system.
- Drs Enterprise
- Eyefinity ExamWRITER
- EyeDoc EMR
- EyeMD EMR
- GE Centricity
- IO Practiceware
- MaximEyes EHR
- Vitera Intergy EHR
- WebChart EHR
To find out about your specific EHR, contact us firstname.lastname@example.org.
If I have an EHR system, how will the IRISTM Registry be integrated?
The Academy's technology partner FIGMD will work with an ophthalmologist's practice to determine how it documents care. Then, FIGMD will use proprietary software to extract data relevant to the IRISTM Registry and automatically transmit it on a scheduled basis. FIGMD has completed integration projects for more than 15 major EHRs and is capable of integrating with new EHR systems quickly.
Can the registry data be used for Physician Quality Reporting System (PQRS) reporting?
The IRISTM Registry is an approved PQRS EHR Data Submission vendor and automates PQRS submission of certified EHR data. For those utilizing a certified EHR (certified to be used in the Medicare and Medicaid EHR Incentive Programs), submission of PQRS data through the IRISTM Registry also satisfies the requirement to report clinical quality measures for meaningful use, as well as the Stage 2 menu measure to report to a specialized registry.
How can the IRISTM Registry inform me about my patient population?
You'll be able to monitor patient care, track interventions and evaluate outcomes at a population level. The IRISTM registry allows users to run queries based on the demographics of an ophthalmologist's patient population for those conditions addressed in the registry. It can help you answer questions such as:
- What is the visual acuity outcome of patients with a specific condition who receive a specific surgery?
- Have all patients with a diagnosis of diabetes received a regular eye exam?
- Have the primary care physicians taking care of these patients with diabetes been made aware of the significance of the exam results?
- What is the rate of return to the operating room for patients undergoing cataract surgery?
How is population management via the ophthalmology registry different than via my EHR?
The IRISTM Registry is focused on specific conditions and patient data only for those patients meeting the registry criteria. Therefore, the report run time is much quicker than that of an EHR, whose registry functions are poorly developed, and often cumbersome to use. It will not slow down or impact an ophthalmologist's data collection and documentation systems in the way pulling such reports from an ophthalmologist's EHR might.
I have reported through the Academy's PQRS registry with Quintiles|Outcome. How is this different?
The Academy's PQRS registry with Quintiles|Outcome was mainly based on data collected retrospectively through claims. For many, this meant that data entry into the registry was still a manual process. The IRISTM Registry extracts PQRS data directly from the EHR, resulting in less manual work for the practice.
Security and Privacy
What identifiable points will be associated with my data?
Practices that join the IRISTM Registry enter into an agreement with the Academy, which includes a HIPAA-compliant Business Associate Agreement. Personal Health Information and identifiable provider information will be captured and stored by the IRISTM Registry in accordance with federal and state laws and regulations. The IRISTM Registry will not publish any identifiable provider or practice data without permission.
Who will have access to my data?
The IRISTM Registry collects, stores and reports on data on an ophthalmologist's behalf, taking every measure possible to safeguard it. The Academy's technology partner, FIGMD, is compliant with all local and federal regulations governing these areas, including HIPAA provisions and the recently updated provisions as part of the American Recovery and Reinvestment Act/Health Information Technology for Economic and Clinical Health.
How will the Academy use the data in the IRISTM Registry?
Based on the aggregate data, the Academy will be able to publish benchmarks that can be used to assess an ophthalmologist's outcomes, practice patterns and utilization of new technology to look at overall trends in the patient population. IRISTM Registry data will also allow the Academy to better focus its educational programming and service offerings for members.
Can or will data from the IRISTM Registry be used by any health plans to evaluate physician performance?
This is not a planned feature upon launch.
Cost and Requirements of Participation
What are the costs for participating in the IRISTM Registry?
The pricing structure for participation in the IRISTM Registry has not yet been determined. However, the first 2,000 registrants will receive complimentary access for two years. (See "How do I get started?" above.).
If I agree to participate, how long is my commitment?
Paid participation would be on an annual subscription basis.
What are the time commitments for my office staff?
The IRISTM Registry will be easy to use, timely and responsive to the needs of the profession. It is designed to require minimal input and data entry from your staff. If integration is done using an EHR, IT staff can expect to spend on average one to two hours per week for three to four weeks to assist in the installation and mapping process. If the process is done manually, office staff can expect to spend no more than three to five minutes per patient for data entry to the Web interface. Following installation, no additional work is required, unless the practice's EHR software is updated in the future. At this time, IT staff will need to repeat the installation and mapping process.
How do I get started?
For most U.S. Academy members, the IRISTM Registry will be available for participation in early 2014. The Academy is, however, offering early access to a limited number of ophthalmic practices to obtain feedback on system performance. If you are interested in early access, contact the Academy by email: email@example.com.
Do you have to be an Academy member to participate in the IRISTM Registry?
Yes. Registry participation is open to U.S.-based practicing Academy members.
Is the IRISTM registry available to optometrists?
Optometrists who are employed as part of an Academy member's practice are eligible to participate.
Can academic medical practices participate in the IRIS Registry?
Any practitioner in the U.S. who is a member of the Academy, regardless of practice setting, can participate in the IRISTM Registry as long as they meet the participation criteria.
As an international ophthalmologist, can I participate?
To ensure the IRIS Registry infrastructure is properly developed with features and functionalities that meets the needs of ophthalmologists, the IRIS Registry is currently only open to Academy members practicing in the United States and its territories. In the future, the Academy will examine expanding the IRIS Registry to include international members.
Are all Academy members in the U.S. expected to participate?
Participation in the registry is not a member requirement, but all members are strongly encouraged to do so. Participation will help improve the quality of care provided by not only their individual practices but by the profession as a whole.
Do all physicians in a practice need to participate in the IRISTM Registry?
It is not required that all physicians participate, but participation by all physicians in the practice is strongly encouraged to generate data that most accurately reflects practice performance.
When will IRISTM Registry users receive their first report? What data will it include?
A week after being mapped, users will be able to receive their first report, which will include PQRS data for their patients.
How can the IRISTM Registry be used for research?
The Academy plans to make aggregate data available for research purposes at a later stage. The Academy has established an oversight group to set IRISTM Registry research and publications policies and procedures.
Will there be costs associated with using the ophthalmology registry for research studies?
This is to be planned at a later stage.
Will the Academy create additional clinical data registries?
Once the IRISTM Registry is fully implemented, future registry topics will be explored.
How will the focus of new registries be decided?
Registry topics will be determined by the Registry Measure Development Workgroup, a panel of Academy members and thought leaders generally representative of ophthalmic clinical practice and priorities.
How do I submit suggestions related to the registry and recommendations for new topics?
Send an email to firstname.lastname@example.org.
Does the IRISTM Registry have any relationship to continuing medical education?
Currently, the IRISTM Registry does not support continuing medical education activities, but there are future plans to leverage the IRISTM Registry to meet CME requirements.