As interventional radiologists continue to strive for quality in patient care, clinical data registries measuring performance and patient-centered outcomes play a vital role. Registries focus on improving quality, patient satisfaction, and efficient resource allocation by providing timely feedback on optimal patient care.
Data registries align with evolving healthcare reimbursement models, which prioritize health outcomes, patient satisfaction, and cost effectiveness. A variety of reimbursement models currently exist to help meet these priorities, including shared saving programs, capitated models, episodic bundled payments, and modified fee-for-service (FFS) payments tied to quality standards.
These all have a common theme of rewarding health teams that save money and meet quality standards. These models incentivize providers to hold down costs by improving clinical outcomes, reducing waste by tracking utilization, and standardizing clinical care, as well as rewarding patient satisfaction. Healthcare teams that are successful in meeting these objectives are rewarded by receiving incentive payments on top of FFS payments. In the more advanced payment models, healthcare teams share in financial risk, facing potential monetary penalties for wasteful or expensive care that leads to less-than-optimal patient outcomes and patient satisfaction.
data required for evaluating healthcare teams in these payment models. Data includes healthcare processes, organizational structure, resource utilization, patient outcomes, and patient satisfaction. Many options exist for collection of data; however, registries have numerous advantages, including timely feedback reports to clinical users. Registries also include benchmarking capabilities locally, regionally, and nationally. Registries can integrate into EHR systems, allowing for easy data extraction.
Another advantage of data registries is the potential for an increased pool of measures specific to a specialty available for submission into the Quality category of the Merit-Based Incentive Payment System, if the registry is approved by CMS as a Qualified Clinical Data Registry. This advantage is particularly meaningful to both diagnostic and interventional radiologists. The ACR’s National Radiology Data Registry® includes many measures applicable to interventional radiologists such as:
- Prevention of central venous catheter-related bloodstream infections
- Rate of endovascular aneurysm repair (EVAR) of small or moderate non-ruptured abdominal aortic aneurysms (AAA) without major complications (discharged to home post-operative day 2)
- Rate of carotid artery stenting (CAS) for asymptomatic patients without major complications (discharged to home post-operative day 2)
- Clinical outcome post-endovascular stroke treatment
- Door-to-puncture time for endovascular stroke treatment
- Varicose vein treatment with saphenous ablation: outcome survey
- Appropriate assessment of retrievable inferior vena cava filters for removal
- Uterine artery embolization technique: documentation of angiographic endpoints and interrogation of ovarian arteries
The Society of Interventional Radiology (SIR) has recently launched its own registry named VIRTEX. This initiative promises to take registry reporting to the next level by standardizing reporting and making quality data tracking and extraction easy for IR procedures. VIRTEX collects patient demographics, medical comorbidities, technical details of the procedure, intra-procedure complications, labs, and patient-reported outcomes.
The registry has also been designed to collect data from follow-up outcomes and from future procedures to ensure longitudinal follow-up and position the SIR to be able to collect quality information for future quality payment programs.
As the registry matures, the data collected will have a powerful impact on proving the benefits of the minimally invasive techniques championed and perfected by interventional radiologists. Tracking patient outcomes and resource use may hold substantial influence when negotiating payments and attracting patients as the world evolves toward data analytics and cost transparency. The registry aims to become a CMS-approved registry during future iterations.
A data registry is a useful method of collecting appropriate clinical data to generate actionable information to improve quality and outcomes. As IR continues to provide patient-centric and cost-effective care, it is imperative for our specialty to participate in data registries as part of our commitment to quality, safety, and improved disease outcomes. This will require further support from CMS and other regulatory bodies to steward additional measures related to diseases that interventional radiologists diagnose and manage.