AAO Report

IRIS registry provides PQRS compliance

By Rich Kirkner, Executive Editor

Taking a page from other medical specialties, the American Academy of Ophthalmology launched an outcomes registry, known as IRIS (for Intelligent Research in Sight) that can enable participating practices to meet Physician Quality Reporting System (PQRS) requirements in 2014 and avoid CMS penalties.

Already 370,000 patient encounters are included in the beta test of the registry, AAO CEO David W. Parke II, MD, said at the opening session of the society’s annual meeting. The AAO projects more than 2,000 ophthalmologists will provide data on 20 million patient encounters by 2015, according to Dr. Parke. The registry utilizes software that can extract masked patient data directly from physicians’ EHRs, although ophthalmologists without EHRs will also be able to participate. A component that attaches to the practice’s EHR system requires about three hours of set-up by a staff person familiar with IT, according to Dr. Parke.

EHR compatible

The component will extract blinded data from the EHR at night and send it to a cloud-based registry. Twelve EHR vendors have already signed on to map their data to IRIS (box). The AAO is offering the registry for free at this point.

The registry serves many purposes besides providing a mechanism for complying with CMS’ PQRS requirements. The primary purpose, Dr. Parke said, “is to enhance the quality of care and safety of ophthalmic practice.”

The secondary goal, he noted, is to provide benchmarking for practices, organizations and individual physicians. The registry will also facilitate Maintenance of Certification for individual physicians in the future, he said.

“This will allow for analysis of trends in ophthalmic practices in a way we haven’t been able to before,” Dr. Parke said. He said participation in IRIS has the potential to generate $20,000 to $40,000 of new revenue for the typical practice.

Cardiology’s experience

Among the medical societies that already utilize outcomes registries are the Society of Thoracic Surgeons, the American College of Surgeons and American College of Cardiology (ACC). David May, MD, PhD, president of the ACC Texas chapter and a member of the PINNACLE registry steering committee, spoke at an AAO panel on how that registry has impacted cardiology.

“Let me assure you that three things will happen with this participation,” Dr. May said. “The first is it will not take any additional time. You will learn very quickly that your work flow already accomplishes the data acquisition and is really just a matter of codifying and collecting it.

“The second is you will engage the team that you work with far more than you have in the past,” he said.

“And third, you will become very proud of the quality of work that you do, because as soon as you begin to get the reports back while on the registry itself, you begin to make changes in your process, your work flow and dramatic improvement takes place.”

The registry will formally launch in February 2014, according to the AAO.

Five mobile technologies unveiled at OIS

By Rich Kirkner, Executive Editor

Five companies developing mobile ophthalmic diagnostic, screening and patient monitoring and education technology presented their innovations at the fifth annual Ophthalmology Innovation Summit last month in New Orleans, where more than 800 ophthalmic innovators and investors convened.

In introducing the companies, Gilbert Kilman, MD, managing director of InterWest Partners venture capital firm, declared, “Paper is becoming a very outdated platform” for patient communications and interactions. Here is a look at the companies and their platforms.

Gobiquity Mobile Health

The initial product, GoCheck Kids, is a smart phone-based app designed to screen for amblyopia in children. “It’s a photography-based app that takes a picture of the eye and generates a refraction from that,” CEO Michael Brownwell said. “The first image measures the horizontal and vertical meridians, and calculates the refraction from those two measures.”

The app is aimed at pediatricians, who can then refer amblyopes to optometrists and ophthalmologists. Gobiquity plans to launch the app next year as an FDA-approved diagnostic device, and is in the midst of a clinical study, Mr. Brownwell said.

Digisite Technologies

CEO Doug Foster introduced SightBook, a cloud-based system for mobile monitoring of patients with wet AMD, retinal vein occlusion and diabetic macular edema, a population he estimated at 2.6 million. The system can tie into a patient’s personal health record and download patient information into a database for research.

The target patient group is “highly motivated to stave off progression of disease,” Mr. Foster said, and many are on treat-and-extend anti-VEGF therapy. “The challenge with treat-and-extend is you really don’t know how the patient is doing between office examinations and office visits,” he said. “Our technology is meant to fill the knowledge gap of what happens after the patient leaves the office.” Multiple clinical trials of the technology are underway.

CheckedUp

This mobile app provides ongoing education and communication that physicians and practices can customize for patients and reinforce what doctors tell patients in the clinic. The program suite includes modalities for health coach, medical alert and drug compliance, said Richard Adweh, MD, CheckedUp CEO and founder.

CheckedUp can help physicians meet the Meaningful Use phase 2 standard of capturing feedback from at least 5% of patients, Dr. Adweh said. CheckedUp automatically alerts physicians about patient preferences so they can personalize their in-person consultations, including pre- and postoperative instructions, he said. CheckedUp is conducting a clinical study of its platform with 100 patients in high-volume clinics.

EyeNetra

EyeNetra has developed NETRA-G, a device cofounder and chief operating office David Schafran described as a “very simple piece of plastic” — a diagnostic that links to a smart phone to measure cylinder, axis and pupillary distance to yield an “eyeglass measurement.”

NETRA-G uses “off-the-shelf” components and interactive mobile phone hardware. The test takes about three minutes, Mr. Schafran said, and it is intended for the consumer to take from home with an optometrist’s guidance via telemedicine. He said the results are comparable with portable autorefractors.

KeepYourSight

A 503c charitable foundation with a mission to develop digital screening tools to prevent blindness worldwide, KeepYourSight has developed two online digital screening tests, said CEO Maria Alexander: Peristat, a visual field test that takes about three minutes; and Mucustat, a macular function test.

“We’re not trying to diagnose disease,” Ms. Alexander said. “We’re just trying to do an initial screening.” When the online test detects any abnormalities, the user gets an e-mail to follow up with a clinician. “Our goal is to drive down the cost of screening from $30 to $1,” she said. OM