IRIS Registry shaping up to be extensive data source

IRIS Registry shaping up
to be extensive data source

By Nancy Groves; Reviewed by William L. Rich III, MD, FACS

The Intelligent Research in Sight (IRIS) Registry-a comprehensive eye disease registry developed by the American Academy of Ophthalmology (AAO)-has far surpassed early estimates for physician participation, according to William L. Rich III, MD, FACS.

The registry has become a comprehensive data source with applications for clinical improvement, data analysis, and scientific research, said Dr. Rich, medical director of health policy for the AAO and chairman of the IRIS Executive Committee.

IRIS was approved by the academy board in late 2012 and launched in April 2014. At the time, Dr. Rich had estimated that by January 2018 the registry would include 2,200 physicians and 8 million patients.

His predictive skills were off-as by October 2017 the registry had contracted with 16,503 physicians from 5,119 practices. Of these, 13,046 physicians from 5,119 practices were integrated into IRIS through electronic health records. The number of patient visits was 166.16 million, representing 41.22 million patients.

“My subsequent estimation of 48 million patients by 2018 is going to hold up, and what that means is that we’re the world’s largest registry, and we’re a much better data source than even the Medicare registry,” Dr. Rich said.

Also heartening is that the IRIS Registry includes about 70% of the practicing ophthalmologists in the United States. Most of those not participating work for the Department of Defense or Veterans Administration or are employed by academic medical centers.

Finding value of IRIS

The value of IRIS can be assessed in several ways, Dr. Rich said. First, it is a tool for quality measurement, benchmarking, and improvement.

“This stems from our culture of better science in patient outcomes and quality,” he added, noting that the AAO began to create evidence-based guidelines in the 1980s and, in the mid-1990s, first attempted to develop a registry. However, the paper-based system had to be scrapped because it interfered with physician workflow, subsequently to be revived when EHR and other technological advances made it more feasible.

IRIS also benefits physicians by streamlining Merit-based Incentive Payments System (MIPS) reporting.

“We have 32,000 physician electronic reporting years without a penalty, so there are financial benefits to those who work in IRIS besides the personal improvement that happens when you look at your dashboard and can compare your results with a huge database,” Dr. Rich said.

The registry also assists physicians with maintenance of certification Part IV and uses aggregate, de-identified data for data analytics and scientific inquiries.

Published studies using IRIS registry data have begun to appear.

“We’re just putting our toes in the water, and now we’re moving onto bigger topics and bigger clinical issues,” Dr. Rich said.

The first publications focused on rare disease entities as a trial of the utility of the registry in data analysis. Studies appearing in 2016 and 2017 in Ophthalmology looked at treatment patterns and prevalence of myopic choroidal neovascularization in the United States, while a 2015 report in the American Journal of Ophthalmology characterized the role of big data in cataract surgery. 

References

1.   Willis, JR et al. Treatment patterns for myopic choroidal neovascularization in the United States. Ophthalmology. 2017;124:935-943.

2.   Willis, JR et al. The prevalence of myopic choroidal neovascularization in the United States. Ophthalmology. 2016;123:1771-1782.

3.   Coleman, AL. How big data informs us about cataract surgery: The LXXII Edward Jackson Memorial Lecture. Am J Ophthalmol. 2015;160:1091-1103.

William L. Rich III, MD, FACS

E: hyasxa@gmail.com

This article was adapted from a presentation given at the 2017 meeting of the American Academy of Ophthalmology.
Dr. Rich did not report any relevant disclosures.