IRIS REGISTRY

A comprehensive ophthalmology patient database that could greatly improve ophthalmic care launches at the end of March, leaders of the American Academy of Ophthalmology (AAO) announced. The IRIS Registry, for Intelligent Research in Sight, debuted at the 2013 AAO annual meeting in New Orleans and is the first of its kind in the US.

“With the wide adoption of electronic health records, the time is right to fully utilise the power of information technology to produce evidence-based, statistically valid information that can help ophthalmologists determine how to improve patient care,” said William L Rich III MD, AAO medical director of health policy.

IRIS is a centralised collection and reporting software tool that compiles and processes data drawn directly from electronic health records in participating ophthalmology practices. It enables ophthalmologists to statistically analyse their own care, compare it to that of their peers and pinpoint opportunities for improvement. The database allows ophthalmologists to manage their patients at a population level; study a specific group of patients based on conditions, risk factors, demographics or outcomes; identify trends and track interventions; and answer specific clinical questions.

Longitudinal record

IRIS was developed with input from several existing registries, including the ESCRS-supported EUREQUO, the Aravind system medical record in India and registries operated by other specialties, Dr Rich said. But unlike most previous registries, IRIS continually collects data on patients before, during and after procedures, creating a longitudinal record rather than one built around discrete episodes of care. He believes that eventually specialty registries will be aggregated into a broader dataset, enabling research into how treatments of one organ or body system affects others.

When it was introduced at the AAO Meeting, the IRIS Registry had been piloted with 120 ophthalmology practices, representing roughly 370,000 patient encounters across 35 states. As of March, more than 400 practices have joined the registry. The AAO estimates that the database will be populated with data from more than 18 million patients by 2016.

One challenge is developing standardised measures for each subspecialty that are clinically meaningful but not overly burdensome to collect, said Michael F Chiang MD, chair of AAO’s Committee on Medical Information Technology, and Knowles Professor of Ophthalmology & Medical Informatics and Clinical Epidemiology at Oregon Health and Science University.

An AAO working group is collaborating with subspecialty groups drafting standards, Dr Chiang said. “Each subspecialty compiles its own panel of specific outcomes of interest. In some cases they are specific clinical or surgical outcomes; in some cases there is interest in disease-specific registries.” The real advantage will be improved care, Dr Chiang said. “Best practice guidelines, side effects of various drugs, postmarketing surveillance – the potential is really amazing.”

Linda Apeles: lapeles@aao.org