Technology and the Future: The American Academy of Ophthalmology and the IRIS Registry

In anticipation of the upcoming American Academy of Ophthalmology (AAO) 2019 annual meeting and following up on a recent webinar on the benefits of the IRIS® Registry, we asked a few questions about the future of technology in ophthalmology.

Ophthalmology is one of the surgical specialties facing a significant shortage of physicians now and in the next several years. Given the context of the mission of the American Academy of Ophthalmology (AAO)—specifically the aspect “to advance the profession of ophthalmology”—what do you think can be done to mitigate the gap?

[Kristi Bolinger] What we’re seeing is that the population of “older” patients is growing, and because of this more patients are needing care in this specialty. By equipping ophthalmologists with the right tools, we can help them advance patient care and enable them to be successful. Both advancement in technology (electronic health records and devices) and education of clinical staff are just a few means to assist ophthalmologists in delivering the highest level of quality care. 

The upcoming American Academy of Ophthalmology Annual Meeting theme is “Inspire.” What inspires you about the field of ophthalmology today and what you see in the future?

[Kristi Bolinger] What has always inspired me about the field of ophthalmology is the progress that has been made over the years. Take cataract surgery alone—cataract surgery used to only involve the removal of the cataract, requiring patients to wear “cataract glasses,” which were extremely heavy and difficult to wear. Then ophthalmologists were able to replace the natural lens with an artificial intraocular lens (IOL). Many improvements to IOL have been made, so some patients can now be completely glasses-free after cataract surgery. There’s so much talent, knowledge, and experience that there’s no limit to the inspiration to create ways to provide even better care.

What do you think will be the most valuable topics and messages at the AAO Annual Meeting—from research to reporting, from practice management to procedural advancements—what do expect to hear that has widespread resonance?

[Kristi Bolinger] I’m most excited to hear about what’s coming next. Hearing what ophthalmologists have found that helps provide less invasive and more efficient care to the patient.

How do you think technology plays a role in the future of ophthalmology?

[Kristi Bolinger] I’m interested to see what is coming to monitor a patient’s ocular health while the patient is at home. Once this becomes more mainstream, virtual visits will soar. Until then, we need to continue to find ways to make the patient’s visit in the office efficient. There’s always more coming relative to device integration—technology continually creates new devices and we will continue to integrate those devices to effortlessly enter findings into a patient’s chart. Documentation tools like remote scribe also helps significantly reduce the burden of documentation while keeping costs down.

What advice would you give independent ophthalmology practices to make best use of the IRIS Registry?

[Dr. Lum] I would advise practices to really make use of the IRIS Registry as a tool for improvements in patient care, patient outcomes, participating with patients to improve their overall health, and evaluating your patient population as a whole. It’s also especially useful for avoiding significant penalties (for 2020 MIPS, the penalty for not reporting MIPS successfully is 9%). For example, there is great value to see which diabetic patients aren’t coming back for a yearly eye exam; why important exam elements might be missed on a visit; and, how to reinforce relationships with primary care physicians and other physicians. It’s also important for continuing a laser focus on the excellent safety and outcomes that patients have come to expect from ophthalmologists in terms of visual acuity results after treatments, low rates of complications after surgeries, etc.

Why is the IRIS Registry the preferred platform for MIPS support? How can the registry help practices improve their scores?

[Dr. Lum] The IRIS Registry reported for the majority of ophthalmologists eligible for MIPS in 2018. The large majority of ophthalmologists who integrated their electronic health records with the IRIS Registry and submitted for 2018 MIPS were eligible for an exceptional performance bonus. The Academy has developed or co-developed nearly all of the eye care quality measures used in MIPS and understands the intent and details of each of these measures. The Academy also has a breadth of experience in quality payment programs and has submitted to CMS on behalf of its members since 2014. The IRIS Registry has Academy staff and client account associates to help practices review their dashboards, explain the quality measure actions for specific measures, pinpoint areas where patients don’t meet the measure, identify areas where documentation can be enhanced, or refine the mapping to capture elements that have been documented in the past.  

Are there any unforeseen advantages to the IRIS Registry that physicians may not realize?  

[Dr. Lum] Active engagement with the IRIS Registry enables ophthalmologists to fulfill the Clinical Data Registry Reporting measure for the Public Health and Clinical Data Exchange Objective for the Promoting Interoperability Performance Category for 2019 MIPS. There are also five Improvement Activities related to use of the IRIS Registry as a Qualified Clinical Data Registry that can be used by practices integrated with their EHRs. Of course, the IRIS Registry is a free member benefit to all Unite States ophthalmologist Academy members in good standing and covers the eligible clinicians that they practice with, e.g., optometrists, nurse anesthetists, physician assistants, nurses, etc.

The Academy provides significant MIPS support via its Eyenet magazine, the aao.org/Medicare website, the e-talk listserv, the Washington Report Express newsletter, and availability of staff through mips@aao.org and irisregistry@aao.org. And those integrated with their EHR can use the IRIS Registry for creating a Registry-Based Improvement in Medical Practice Activity application to earn credit for MOC. 

In addition, practices integrated with their EHR are eligible to use the free Practice Insights tool provided by the Academy and Verana Health to apply analytics to provide data insights and visualizations. The initial version of the Practice Insights tool will allow practices to benchmark their volume of cataract surgery procedures relative to other practices and future versions will expand to other indications by 2020.

Listen to the webinar to learn more from Dr. Lum on the benefits of using the IRIS Registry and how to leverage your clinical data to improve care delivery and patient outcomes.