The AAO registry project: A basic primer

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The American Academy of Ophthalmology has developed the Intelligent Research in Sight Registry, the first compressive eye disease outpatient clinical registry in the United States.

By Liz Meszaros; Reviewed by David Glasser, MD

Baltimore, MD-The Intelligent Research in Sight (IRIS) Registry will be the first comprehensive eye disease outpatient clinical registry in the United States, and is being developed by the American Academy of Ophthalmology (AAO) as part of the shared goal of continued quality improvement in eye care delivery, said. David Glasser, MD.

“The ophthalmic clinical registry may represent a seminal change in how we improve our performance and outcomes while we shorten the timeline for the dissemination of important clinical knowledge, expand research opportunities and facilitate drug and device surveillance,” said Dr. Glasser, Assistant Professor of Ophthalmology at Johns Hopkins University School of Medicine, Baltimore, MD, and President of the Maryland Society of Eye Physicians and Surgeons. “To do so it must have broad input from the specialists, have a viable business plan, and not adversely affect physician work flow.”

Understanding IRIS

The IRIS Registry will be a centralized system where ophthalmologists can both promote practice innovations and achieve clinical excellence, and it will provide the following:

·     Easy-to-interpret benchmark reports that validate the quality of care being provided and identify specific opportunities for improvement.

·     Access to clinically relevant data on diseases, including age-related macular degeneration, cataract, and glaucoma.

·     Quality measurement solutions to help practices qualify for pay-for-performance incentives and avoid value based modifier penalties.

·     Automated data collection through electronic health records (EHRs) that will fit seamlessly into practice workflow.

The mission statement of the IRIS: AAO Clinical Registry is, “to develop a registry of ophthalmologic ambulatory encounters with little impact on office work flow, which captures essential data elements for continuous quality improvement efforts, maintenance of certification activities, enhanced patient care outcomes, and pay for performance programs.”

The measure development group is made up of a core unit of experts with experience in measure specifications and medical informatics, and will include subspecialty and vendor consultants as needed. The guiding principles of the measure development group are to ensure integration between EHRs and the registry, minimizing the data entry burden on practitioners, Dr. Glasser added. 

Registry benefits

According to Dr. Glasser, the benefits the IRIS Registry will bring to the profession of ophthalmology include:

·       Quality improvement through benchmarking performance and improving performance and patient outcomes.

·       Financial compensation through received payment incentives and avoidance of payment penalties.

·       Maintenance of certification/licensure through meeting the requirements for MOC/MOL.

In addition, the IRIS Registry will be able to facilitate meeting ‘meaningful use’ EHR requirements, establish an infrastructure and clinical research backbone for specialty research endeavors, such as a corneal graft registry or DRCR.net, enable drug and device surveillance, and allow data collection to address disparities in care and outcomes.

The principles of the IRIS registry are as follows:

·       Ophthalmologists own their own data.

·       The Academy owns aggregated, de-identified data.

·       Data protection/security is in place and is paramount

·       Ophthalmologists give permission for their own data to be distributed and reported.

·       MD-specific data protected from discovery.

·       Burden of data entry should be minimized.

Three methods of data entry are available.  The simplest employs a systems integrator, which maps to the practitioner’s EHR and makes data entry automatic. Seventeen EHR vendors have already been successfully mapped and others are in process. Data can also be entered via the web or on paper, but these are much more labor intensive, with a negative impact on workflow.

Ophthalmologists are encouraged to sign up at www.aao.org/iris-registry. Registration and participation are free.  There are currently 2,584 physicians from 560 practices that have contracted with the IRIS registry, with 1,083 of them from 180 practices who have successfully mapped to their EHR.

David B. Glasser, MD

P: 443/283-8800

Dr. Glasser has no financial disclosures.