In 2020, SIR joined many other specialty organizations to develop a clinical data registry. The VIRTEX registry has been an organization-wide effort and the Quality and Performance Improvement (QPI) Division has been central to its development. Below, the QPI committee chairs discuss the creation and value of the VIRTEX registry and answer some common FAQs.
QPI Committee Chairs:
- Drew M. Caplin, MD, FSIR, Practice Improvement and Change Committee
- Resmi Charalel, MD, MPH, Quality Data and Analytics Committee, Co-chair
- Juan Martin Gimenez, MD, Quality Data and Analytics Committee, Co-chair
- Jeremy D. Collins, MD, FSIR, Standardized Reporting Committee
- Thomas J. Ward, MD, Performance and Outcomes Measurement Committee
What spurred the registry development?
Virtually every major primary specialty has a data or quality registry. IR has been recognized as a primary specialty but has lacked a comprehensive, specialty-wide registry devoted solely to our expertise. VIRTEX will provide IRs with the depth of evidence needed to forge ahead in demonstrating the capabilities and potential of IR. VIRTEX will be a hub of knowledge that will continue to advance the standing of IR among medical specialties and show that IR therapies can be first-line solutions that are often less invasive and more efficient than traditional approaches, while delivering equivalent or better outcomes.
What are the benefits of participating in the registry?
VIRTEX collects the measurement of your performance and displays near-real-time data directly to you through a dashboard powered by an industry-leading analytics platform. This will allow you to identify areas that you excel in, target areas that may fall below the benchmarks for improvement and compare performance. VIRTEX will allow for not only internal tracking of performance, but also the ability to benchmark regionally, nationally and among specific peer groups.
Why use the SIR standardized reports and PowerScribe to participate in the registry?
The SIR standardized reports allow the data collected in the registry to be consistent and usable. It structures the information into specific verbiage and lists. Nuance PowerScribe® 36 allows the data to be transferred electronically without the need for manual abstraction of data into the registry, which is infeasible in most practices. While we recognize that not all sites and practices use PowerScribe, it was chosen due to its wide adoption across IR. Though the intermediate-term plans include incorporation of other reporting systems, it was necessary to focus our efforts for the initial launch to keep the rollout manageable. The next phase of the registry will incorporate integration with EHRs to capture data such as lab values and more.
What would you say to those who feel the reports are too cumbersome to install or use?
Many who have been using the reports have provided feedback that they quickly become easy to use. The structured aspect of the reports is what makes this registry so powerful. It allows for very precise data collection.
Think about data you enter when you register for a new online account (e.g., a music streaming account). You are asked to select genres or individual artists that you like from a list. You are then asked to like or dislike songs. In this way, a precise profile is created.
Now imagine if you simply typed in a list of bands and genres you liked in a paragraph—there would be virtually no way to easily create the same profile and compare you with other users since you might misspell a band name, categorize a rock band as a pop band, or even make up your own genre.
VIRTEX will be a hub of knowledge that will continue to advance the standing of IR among medical specialties and show that IR therapies can be first-line solutions that are often less invasive and more efficient than traditional approaches, while delivering equivalent or better outcomes.
Despite advances in natural language processing and machine learning, separating narrative data remains incredibly difficult. Yet, we recognize that this is medicine and not music. Users have the option to customize the report by adding narrative text and moving modules around the report. There will be an improved and updated version provided directly to registry participants with added features, including the ability to track adverse events.
The reports, which are available in both XML and RTF formats, can be customized according to your preferences and, as long as no critical elements are changed, you have the option to customize the report to fit your needs and still be able to participate in the registry.
How can I convince stakeholders like my partners or my institution’s administration to join the registry?
VIRTEX will provide benefits at several different levels:
At the individual provider level, it will allow direct access to patient-reported outcomes, such as pain scores, a pathway to meet MOC requirements and dashboard to view their performance over time. Quality metrics can be easily tracked. Private practices can participate with minimal infrastructure requirements.
At the practice level, VIRTEX provides a measurable, quantifiable and methodical way to demonstrate care across providers and the ability to use the registry to satisfy quality mandates including MIPS. Quality measures in the registry can be used for group MIPS reporting, offering a unique way for IR partners to help improve their group’s QPP score.
At the site or institution level, it can provide a means to standardize the quality of care delivered among different locations, compare performance to peer institutions, provide data to administration on performance and provide a pathway for meeting coverage and reimbursement requirements without investing in the informatics resources to build this locally. The registry provides clinically relevant, timely and actionable, risk-adjusted self-assessment data to analyze patient outcomes over time and meet quality improvement goals.
How can this support our existing QI program? Can it help us start one?
Institutions more than likely have a quality improvement or equivalent department focused on improving areas such as patient satisfaction, infection prevention, complication rates, etc. VIRTEX will provide participating sites the data to facilitate a continuous rapid cycle of learning and process improvement to demonstrate IRs’ contribution to quality efforts. The registry can help with projects such as Plan-Do-Study/Check-Act (PDSA/PDCA) cycles. Data is provided in real-time, allowing you to monitor your progress, compare to peer groups and improve patient outcomes. This will also allow private practices or smaller providers that may not have the resources of a larger site or practice to efficiently implement and/or maintain a QI program. The best practices of institutions performing at or better than the benchmark will be published on the SIR website, sirweb.org, for participants to utilize.
Will the registry be used for research purposes?
We are counting on the data from the registry to be a large driver of research efforts going forward. The data may be used in the future for pilot data, in publications and for collaborations across specialties. Having registry data will be invaluable to demonstrate the effectiveness of IR therapies to patients, payers, our diagnostic partners and our clinical colleagues. Importantly, access to such data for novel therapies is essential when engaging in coverage discussions with payers. HIPAA and privacy regulations will be followed when using registry data for research.
How will the registry help IR collaborate with other specialties and regulatory agencies, such as CMS and the FDA?
We will have evidence-based data and outcomes that can support discussions regarding reimbursement, coding, quality, techniques, procedures and medical devices. It will allow for greater collaboration with other specialty societies regarding specific disease states, procedures and outcomes. The registry is already engaging with several specialties to standardize data elements to ensure harmonization.
How will this improve measure creation and clinical guidelines?
Data from the registry will allow us to create and refine relevant and appropriate IR specific clinical quality measures, thus enabling us to define what quality care means for IR. As SIR develops multidisciplinary, evidence-based guidelines, recommendations from the guidelines will be integrated into the VIRTEX platform so that SIR members have the published data to use in a more timely way rather than waiting for best practices to be disseminated through traditional means. As guidelines are updated and created, this will lead to the creation of additional measures.
Why should I participate in the VIRTEX registry instead of other radiology or disease state-specific registries?
The VIRTEX registry will be comprehensive. It does not focus on only one disease state, outcome or procedure. It has been developed for IRs by IRs. Additionally, SIR has chosen to keep the fees to participate very low compared to other registries so that cost is not a hinderance in participating, especially if participation is in addition to other registries. The VIRTEX registry also features automated data capture, unlike other registries that rely on manual data abstraction.
Why should I be an early adopter/pilot site? I would rather wait until others work out any issues.
Being an early adopter allows you to get your data faster, treat your patients with more data to support your decisions and be recognized as a trailblazer in shaping the registry from the very beginning. Your participation and feedback will help define the registry for yourself and future users.
When will the registry launch?
December 2020–January 2021.
Who can I contact to learn more?
Contact the VIRTEX SIR data registry team at sirregistry@sirweb.org or visit sirweb.org/virtex.
