March 2016 - Vol. 35, No. 02

Regent℠ progress report
AAO-HSNF’s first clinical data registry takes shape with pilot, quality measures, and governance We last provided a comprehensive update of RegentSM in the December/January Bulletin as part of the AAO-HNS Annual Report. In the past three months, the Foundation has made tremendous strides in the construction of Regent, including the recruitment of pilot sites, development of measures and the Regent data dictionary, and the creation of a governance structure. Additionally, the AAO-HNSF has filed with the Centers for Medicare & Medicaid Services (CMS) to allow practitioners to report quality data to CMS. We welcome this opportunity to provide you a detailed update on Regent, the Otolaryngology Clinical Data Registry. Regent pilot The Regent pilot is officially underway and AAO-HNSF staff is working closely with our vendor, FIGmd, Inc., to orient and process 38 diverse sites that represent the depth and breadth of otolaryngology practice settings, including hospital-based practices, academic medical center practices, and private practitioners. This pilot phase is a critical step in the development of Regent and will enable the AAO-HNSF to test its performance measures, ensure accuracy and reliability of extracted data, increase our understanding of practices’ needs for educational tools and resources, and identify and solve any roadblocks encountered along the way. The pilot will also ensure that the appropriate technology architecture and practice support are in place prior to the full-scale launch of Regent. In recruiting sites for our pilot, we had very specific needs for a diversity of sites and electronic health records (EHRs). The response to our recruiting efforts was overwhelming. The AAO-HNSF received a large number of requests and FIGmd recommended setting a limit of 35 to 40 site participants for the pilot. We deeply thank all of our Members for the overwhelming demonstration of support and commitment to Regent and look forward to working with each of you in the future. Also, for Members who had their badges scanned as part of the Regent Miniseminar or at the Regent Booth at the 2015 AAO-HNSF Annual Meeting & OTO EXPOSM, and expressed interest in the free one-year participation in Regent, we will be contacting each of you this spring—well before the Regent pilot concludes—with instructions and deadlines for securing this offer for the full launch of Regent in mid-2016. Quality measures and Regent Thanks to guidance from Richard M. Rosenfeld, MD, MPH, Performance Measures Task Force chair, Lisa Ishii, MD, MHS, former chair of the Registry Task Force and member of the Regent Executive Committee, feedback from the Large Group Forum, AAO-HNSF, and input provided by James C. Denneny III, MD, staff quickly refined the final list of Regent pilot measures and specified six new outcome measure options for our Members to utilize in Regent. Staff worked extensively with FIGmd to create the data dictionary of all required data elements to support the extraction and reporting of the measures in a registry environment. The final list of pilot measures includes 30 current PQRS measures and 12 non-PQRS measures. In addition to existing otitis media with effusion (OME) measures, the non-PQRS measures comprise a new measure regarding the avoidance of intranasal corticosteroids for OME, as well as newly developed outcomes measures, including the resolution of OME after tympanostomy tube placement and four new tonsillectomy outcomes measures, addressing primary and secondary post-tonsillectomy hemorrhage in both children and adults. It is important to note that quality reporting to CMS is just the first phase of the registry and that measure development is now an ongoing activity. With the creation of the governance structure and seven advisory specialty groups, the goal is to have meaningful quality measures in place for our entire membership. Visit to view the measures contained in Regent. Quality reporting to CMS with Regent AAO-HNSF staff also completed the required application materials and submitted to CMS to secure both Qualified Clinical Data Registry and PQRS Qualified Registry Status for Regent. These materials were submitted in advance of the deadline of January 31, and included the provision of data validation plans, a series of attestations, a complete list of measures, and detailed specifications for each non-PQRS measure. The AAO-HNSF anticipates a response from CMS in early spring regarding the status of our application. Regent has also been constructed with the future in mind to support future measures reporting needs under the Merit-Based Incentive Payment System (MIPS) and other quality reporting programs. Governance and oversight The Executive Committee of the AAO-HNSF approved the governance structure and the appointment of the following individuals to the Regent Executive Committee: James C. Denneny III, MD, chair William R. Blythe, MD Michael G. Glenn, MD Lisa E. Ishii, MD, MHS Melissa A. Pynnonen, MD Jennifer J. Shin, MD, SM Lauren S. Zaretsky, MD Robert H. Miller, MD, MBA, ex-officio The Regent Executive Committee will have responsibility for strategic planning, priorities, and goal setting, while also monitoring the regulatory environment, governing the data contained in Regent, and overseeing quality improvement efforts. In the near term, it is anticipated that the Executive Committee will be actively involved in oversight of the Regent pilot and will be working to develop policies and procedures for critical aspects of Regent prior to its full launch in the summer of 2016. We look forward to the future growth and development of Regent and to reporting pilot results before the AAO-HNSF Annual Meeting & OTO EXPOSM September 18-21 in San Diego. In the meantime, make sure to visit to stay up to date. If you have any questions, please email
New task forces focus on education
By Sonya Malekzadeh, MD, AAO-HNSF former Coordinator for Education The AAO-HNS/F has assembled four education task forces to address important issues concerning our Members and the profession. I am honored to be involved in many of these efforts and to serve as chair for two of these groups. The Simulation Task Force was formed in 2011 to define the current state of simulation, to investigate its role and future potential in otolaryngology-head and neck surgery, and to provide educational resources for AAO-HNS Members. Under the leadership of Ellen S. Deutsch, MD, the Simulation Task Force has accomplished: Initiation of Simulation Open Forums, at both the Combined Otolaryngology Spring Meetings (COSM) and the AAO-HNSF Annual Meeting & OTO EXPOSM, has brought together like-minded individuals to discuss interests, challenges, and opportunities in simulation. An active ENTConnect community engages simulation Members in ongoing collaboration and exploration. Launch of the SimTube Project, a national initiative for simulation-based educational research with the immediate goal of assessing the usefulness of a low-cost, low-tech simulator in learning myringotomy and tube placement, and the larger goal of establishing an infrastructure that could support multiprogram collaboration for more complex simulation-based educational research in the future. More than 60 U.S. residency programs now participate in the study. Numerous Annual Meeting Miniseminars highlighting current education efforts and advanced technology in simulation while also demonstrating the value of simulation in quality of care and systems improvement. Recognizing the expanding role of simulation in education, research, and quality, the task force has recently submitted an application to become a Foundation committee. This new designation will permit a formal and permanent structure for furthering Member opportunities and engagement. Dr. Deutsch and Gregory J. Wiet, MD, will chair the committee. The Comprehensive Curriculum Task Force stemmed from the 2013 Board of Directors Strategic Planning meeting where Academy leadership acknowledged the need for a core curriculum in otolaryngology. The Otolaryngology Comprehensive Curriculum will serve as a lifelong, continually expanding learning and assessment tool for otolaryngology professionals. The content and structure will meet the needs of students, residents, allied health colleagues, and all practicing physicians engaged in MOC and lifelong learning. The online format will cover the otolaryngology scope of knowledge, provided in various educational formats, to guide and address cognitive and technical skills. The “living” content will be kept current with frequent updates so users can be assured they are participating in a rich and growing educational program. The task force believes this to be an ideal opportunity to unite the specialties around education, reduce duplicative efforts across societies, and to provide a comprehensive education platform for our specialty. A working group comprised of society representatives is finalizing a list of topics and performing an inventory of all existing education content across the specialties. This information will inform the development of future education programming. The Intraoperative Nerve Monitoring Task Force, in existence since fall 2015, will address key issues relevant to facial nerve monitoring during otologic and neuro-otologic surgery. With representation from the American Neurotology Society (ANS) and the American Otological Society (AOS), the task force will focus on: Determining current practice in training and performance of nerve monitoring among Academy Members and Residency Program Directors. Developing education activities that will provide uniform and standardized training for otolaryngologists to safely and successfully perform the procedure. Clarifying the AAO-HNS/F perspective on intraoperative nerve monitoring within the specialty. AAO-HNS President Sujana S. Chandrasekhar, MD, proposed the latest group, Advanced Practice Professionals (APP) Education Task Force. With the growing presence of mid-level providers in otolaryngology practices, it is imperative that we provide our colleagues with proper education and training in our field. These efforts will improve their contributions to our practices and patients while also educating AAO-HNS Members on the benefits of including APPs in the profession. In collaboration with the APP societies, including SPAO-HNS, the task force will design educational programing and provide resources that will allow advanced practice providers and otolaryngologist-head and neck surgeons to work synergistically to improve patient care. “I have every confidence that this task force will put together a comprehensive ENT APP curriculum, utilizing many Academy resources. Establishing such an educational outline will really help our Members as they seek to incorporate APPs into their practices” said Dr. Chandrasekhar. Karen T. Pitman, MD, and Peter D. Costantino, MD, will serve as chairs of this new task force. Academy task force Members are working hard on topics critical to the Academy and the profession. “These education task forces really complement the work of the education committees by addressing new and innovative education opportunities for our Members,” said Richard V. Smith, MD, coordinator for Education. If you are interested in more information or contributing to any of these projects please email