Building Tomorrow's Research Today: Reg-ent^SM

Rahul K. Shah, MD, MBA
AAO-HNS/F Executive Vice President and CEOOne of the key reasons I jumped at the opportunity to be your EVP and CEO is Reg-ent. I was fortunate to have been a part of the very early stages of Reg-ent a decade ago and played a foundational role in pediatric NSQIP. When considering the opportunity to lead your Academy, I viewed Reg-ent as one of the most valuable assets our Academy has. This is because sustainable success requires anticipating change rather than reacting to it. In academic medicine and clinical research, we're witnessing a fundamental shift in funding landscapes that demands this forward-thinking approach. Support from the National Institutes of Health (NIH), once the cornerstone of a research career, can no longer be considered such, nor can it be depended on as such. Traditional funding mechanisms are no longer stable, nor sufficient to support the depth and breadth of research our specialty requires to advance patient care.

Reg-ent represents one of the most strategic investments we've made as an Academy. What began as a clinical data registry has evolved into something far more powerful: a robust research platform that positions our specialty to thrive regardless of external funding uncertainties.

The Foundation We've Built

The numbers speak to our collective achievement: Reg-ent has grown to over 50 million patient visits from 11 million unique patients, making it the largest national otolaryngology-specific clinical data repository. With over 2,100 clinicians participating, we've created something unprecedented in our specialty's history—a comprehensive dataset that captures the true breadth of otolaryngologic care across diverse practice settings.

But data collection was never our end goal. As I discussed in my previous column on modernization, we're building solutions that provide outsized advantages for our members. Reg-ent exemplifies this philosophy, transforming from a platform initially designed for reimbursement into a strategic research infrastructure that serves both our specialty and the public good.

Navigating the New Research Reality

The traditional model of research funding is evolving rapidly. While NIH grants remain vital, their unpredictable availability and lengthy timelines often prevent us from addressing urgent clinical questions. Meanwhile, regulatory agencies and payers increasingly demand real-world evidence to support clinical decisions and reimbursement policies.

Reg-ent addresses this challenge through what I call a "hybrid model"—a platform that facilitates high-quality research through partnerships with industry and external sources while maintaining our commitment to scientific integrity and public benefit.

A Modular Advantage

Reg-ent incorporates both structured and unstructured EHR data as well as ancillary data including audiograms, Patient Reported Outcomes (PROs), radiology reports, and laboratory reports. Inclusion of PROs exemplifies this modular approach—specialized components that integrate within Reg-ent to enhance data gathering and research capabilities. This design thinking reflects the same principles we emphasized in our Strategic Plan: We're building infrastructure that adapts to emerging needs while maintaining our core vision of optimizing quality ear, nose, and throat patient care. We continue to significantly invest in the behind-the-scenes workings of Reg-ent to bring artificial intelligence (AI) models and tools to this vast data set. We have barely scraped the surface of what AI integration can do for Reg-ent.

Pilot Data: The Research Catalyst

One of Reg-ent's most powerful features is its ability to generate pilot data rapidly. Whether supporting industry partners in the development of new technologies/therapeutics or academic investigators seeking preliminary data for grant applications, Reg-ent provides the foundation for hypothesis generation and protocol development. Our first published pilot study evaluated the Volume and Practice-Setting Shift of Laryngology Procedures During the COVID-19 Pandemic,¹ demonstrating how we can respond to emerging clinical questions. This capability positions our specialty as leaders in evidence generation. We have veracity on the data “in” because it comes from our participants' practices, hence we can assure the data “out” is of a gold standard.

Industry Partnerships That Serve Public Good

Building on the collaborative philosophy I outlined in my recent column on industry partnerships, Reg-ent enables ethical collaborations that benefit all stakeholders. Industry partners gain access to real-world data that improves their products and services, while our specialty retains control over research priorities and maintains scientific independence.

We envision Reg-ent members being able to participate in clinical trial research opportunities. This will create a sustainable model where research excellence generates resources for further investigation—a virtuous cycle that serves both our members and the patients we treat.

Retrospective analysis reveals that Reg-ent participants, on average, receive higher payment adjustments compared to their non-Reg-ent counterparts, with participants averaging 84.3 points compared to 79.9 points for otolaryngologists not reporting through Reg-ent, translating to a significantly higher payment adjustment. But the true advantage extends far beyond MIPS reporting. By participating in Reg-ent, our members become partners in defining the future of our specialty.

Reg-ent is entering the next phase with the integration of AI modeling, further addition of academic sites, and expanded research opportunities. This evolution reflects our commitment to the Day One mentality I've emphasized since joining the Academy—we don't wait for change; we create it.

The funding landscape for medical research will continue to evolve, but our specialty's longstanding commitment to evidence-based practice remains constant. Through Reg-ent, we've built the infrastructure to generate that evidence regardless of external funding uncertainties.

The question isn't whether research funding will become more challenging; it's whether our specialty will be prepared to thrive despite those challenges. Reg-ent ensures we will be. Together, we're not just collecting data; we're building the research foundation that will serve otolaryngology-head and neck surgery for decades to come.

Your participation in Reg-ent isn't just about your practice—it's about our specialty's research future. Join us in building tomorrow's evidence today.

If you will be at the AAO-HNSF 2025 Annual Meeting & OTO EXPO in October, I encourage you to stop by the AAO-HNSF Research and Quality Information Hub in the OTO EXPO to talk to the staff, see live demonstrations of the Reg-ent dashboard and data, and learn more about the capabilities of Reg-ent today, driving the future of our specialty’s tomorrow.

Reference

1. Gray R, Ryan MA, Mehta V. Volume and Practice-Setting Shift of Laryngology Procedures During the COVID-19 Pandemic: A Reg-ent Database Analysis. OTO Open. 2024 Apr 8;8(2):e128.