A Bright Future for Data Insights in Ophthalmology


David W. Parke II, MD

The IRIS® Registry (Intelligent Research in Sight) was established in 2014 to help members of the American Academy of Ophthalmology (Academy) participate in Medicare quality reporting, improve patient care, and to drive scientific discovery and innovation in our field.

We made the IRIS Registry a member benefit, with no charge for initial setup or participation. It supports more than 60 electronic health records (EHR) systems, ensuring that data can be gathered, and reporting accomplished for practices large and small, all across the country. This has led to very high rates of participation, with more than 14,000 ophthalmologists and their 3,300 employed optometrists, and includes data from approximately 400 million patient encounters and about 70 million unique patients. This is a scale that is unique not only in U.S.  ophthalmology but also in medicine worldwide.

Data Management Partnership Benefits Ophthalmologists

With this scale comes great responsibility. Data security and privacy are of paramount importance to the Academy, so we select our partners very carefully. In 2017, the Academy licensed the commercialization of de-identified, anonymized data to Verana Health to help accelerate clinical research and drive innovations in medicine based on real-world evidence. Verana Health has never released (and cannot release) any physician-specific or patient-specific information to a third party. In fact, because of Verana Health’s accuracy and controls, the partnership has grown, and Verana Health has now become the Academy’s end-to-end data management partner, with more and more practices migrating to Verana Health’s platform for direct data integration with their EHRs. Additionally, the financial support Verana Health provides to the Academy through this partnership has made it possible for the IRIS Registry to continue as a free member benefit. 

The IRIS Registry has been incredibly fruitful for our members, particularly in facilitating compliance with the Centers for Medicare and Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS). Going forward, Verana Health will continue the successes of MIPS reporting, with dedicated customer service and new scoring algorithms maintained by in-house quality reporting experts to ensure that practices can maximize the accuracy of their MIPS scores. To date, no Academy member submitting electronically for MIPS via the IRIS Registry has ever received a penalty. Based on estimated penalties for the average Medicare Fee Schedule for ophthalmologists, we estimate this service saved our members more than $1 billion from 2017 through 2020.

Data Insights Improve Patient Care

We have also reaped scientific rewards that ultimately benefit patient care. In just a few short years, IRIS Registry data has led to more than 25 published, peer-reviewed manuscripts and more than 100 scientific presentations and posters. By aggregating data from so many EHR systems, we have deepened clinical insights beyond what is possible from smaller studies. Researchers have used IRIS Registry data to make novel observations in areas as diverse as diabetic retinopathy, myopic macular degeneration, glaucoma, and endophthalmitis, for the benefit of ophthalmologists and their patients across the country. For example, by identifying risk factors for rare complications of cataract surgery, surgeons may be able to protect more patients against vision loss. Or, by elucidating characteristics that contribute to AMD patients missing injection appointments, outreach efforts can be focused on at-risk patient populations to improve outcomes. IRIS Registry data has also informed discussions on health equity and disparities in care for glaucoma and amblyopia.

The Future Holds Great Promise

We have still only scratched the surface of the IRIS Registry’s potential. As the Academy continues to work with our trusted partner, Verana Health, to expand the data set to include images, claims, patient-reported outcomes, and artificial intelligence-infused analytics, there is much more we can do to advance the future of ophthalmology for both patients and physicians.

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