PRO 2.0 VENOUS REGISTRY: SO, WHAT’S IN IT FOR ME?

By Dr. Joseph Jenkins, Chair of the PRO Registry Operations Committee

The PRO 2.0 Venous Registry is collecting data. The Research Committee has created writing groups. The initial questions concerning venous disease and its different treatments have been posed. The data analysis is beginning. The registry has the potential of gaining an entirely new understanding of venous reflux disease to include the patient’s standpoint. This is secondary to the patientreported outcome (PRO) component. Members of the American Vein & Lymphatic Society may question why they should be part of the registry. As one ponders joining, the following question comes to mind. So, what’s in it for me? Let’s see if I can provide an answer. PRO 2.0 Venous Registry has expanded on the original registry. The original PRO 1.0 registry focused on superficial venous disease. PRO 2.0 has a newly developed component that deals with deep and pelvic vein disease and treatment. Thus, we should be able to provide answers to questions that arise within the area of deep vein therapy. The compression therapy module underwent an extensive redesign. Compression therapy is a non-invasive treatment for venous disease. Compression is just not something that is a requirement of medical necessity from health insurance companies. When dealing with venous ulcerations, compression is a vital component of treatment. Data analysis of the registry’s compression therapy aspect should allow for a better understanding of non-invasive treatments when faced with venous reflux disease. The number of patient encounters within the registry is mine blowing. With over 100 current providers uploading data, the number of patients undergoing a given treatment is in the thousands. The power of such numbers allows for analysis that will establish standards of care. The potential is for AVLS to develop guidelines concerning vein care. With guidelines and standards of care, venous disease specific quality measures are created. The quality measures can then be used to provide CMS with information that fulfills the MIPS/MACRA requirement. No longer will a vein practice struggle with finding quality measures that have nothing to do with vein practice to prevent penalties. The registry should provide the means to have numerous vein specific quality measures. Thus, a provider involved mainly in caring for patients with venous disease should give the required CMS documentation for MIPS reporting via the registry of only vein-specific quality measures. With guidelines and standards of care comes advocacy. The AVLS will work with private insurance companies to defend the vein care that practices are trying to provide. The patientreported outcomes concerning treatment will give a new perspective on the various vein treatments. The labeling of vein treatments as experimental will hopefully be a thing of the past. The analysis of the data should provide the answers to private payers’ questions. Thus, a provider will treat in a way they feel is most appropriate

for a given patient, significantly minimizing the possibility of health insurance denial. Finally, there is the ability for an individual provider to the registry to have access to dashboards when logged into the registry. The dashboards will provide an individual with the ability to look at their own data and understand their practice makeup. PRO Registry users will see the age distribution of the patients, gender, breakdown of veins treated, and more. However, the dashboard’s most significant power will be for users to compare their practice to the aggregate of all providers in the database. One will now have a way to see how their practice compares with others, whether it is similar to the median, undertreating, or overtreating patients. The following are examples of a few of the dashboards that have been created. There are more currently in development.

So, what is in it for me? I would have to say plenty. One just has to take a look at the potential offerings the registry provides to the world of vein care to see the benefit. The dashboards’ potential comparison offerings will provide a level of help not seen within the field of Phlebology previously. The registry benefit for all does

not just happen. It requires a commitment from AVLS staff and volunteers. There is a great deal of work still to complete. Please consider volunteering in a position with one of the research writing groups. As the data is analyzed, then the standards of care and guidelines need to be developed, volunteer for a position with the Guidelines Committee. There is also a need for quality measure development. Please consider becoming involved with that aspect. As one becomes involved in the various components to the PRO 2.0 Registry, you will see the further benefit of this work on the individual provider.