Medical Imaging Meets Meaningful Use

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One of the most misunderstood, murky and maligned healthcare terms is meaningful use. The concept is particularly vexing for radiology departments as medical imaging represents the apex of meaningful deployment of IT, yet the specialty was overlooked in preliminary meaningful use (MU) discussions. That’s all changed. “We can’t have an effective electronic health information system that can’t move images,” says David Blumenthal, MD, chair of the Office of the National Coordinator for Health IT. Now is the time for radiology to tune in to get in on the incentives.

Last fall when the Centers for Medicare & Medicaid Services (CMS) released the MU final rule, the agency modified its requirements so that more than 90 percent of radiologists could meet the definition of eligible providers (EPs), and thus will qualify for incentives of up to $44,000 over five years beginning in 2011 (October 1). To be eligible for incentives, radiologists must be enrolled in CMS and qualify under Medicare or Medicaid.

The aggregate financial impact is tremendous, with more than $1.5 billion in incentives available for radiologists. Large practices could reap nearly $10 million.

However, six and seven figure incentives don’t come without strings attached, and in the case of MU, the requirements, permutations and complexities are staggering. That’s partly because the EMR is the sole component of MU compliance for most providers. However, unlike other eligible providers, radiologists do not interact with the EMR, which means radiology practices need to rely on other, less straightforward paths to MU. Most practices will focus on modular certification of multiple systems.

Eligibility for incentives depends upon the individual radiologist’s practice scenario, but, regardless of the practice setting, each radiologist will be required to purchase and attest to the use of certified technology that meets each of the 25 MU measures or file for an exclusion of individual measures.

Vendors are responsible for certifying IT systems. Practices considering an MU application should check with vendors regarding their certification plans and anticipated timelines. Lists of certified systems can be found on the website of the Office of the National Coordinator for Health IT. In addition, healthcare organizations need to certify any homegrown systems that will be used to meet specific measures. Finally, physicians need to individually attest to MU in year one.

Some capabilities to meet MU measures may reside with existing infrastructure such as RIS, PACS and reporting systems. “We’re confident that our integrated RIS/PACS technology will enable us to meet 60 to 70 percent of meaningful use measures. We’re looking at additional systems to bring us the rest of the way,” explains Andy Wuertele, COO of East River Medical Imaging, a 12-radiologist practice serving five locations in New York City. He anticipates leveraging the CD burning capacity of the practice’s PACS to meet the requirement to provide patients with an electronic copy of health information. RIS, on the other hand, is a veritable MU powerhouse, facilitating compliance with recording demographics and smoking status, issuing patient reminders and much more.

In many instances, the practice may need to invest in additional systems such as decision support, data mining, image sharing or patient portals to meet one or more MU measures. East River Medical Imaging plans to upgrade its RIS to include a patient portal feature that provides patient-specific education resources, thus meeting an additional MU measure.

Clearly, there’s no one-size-fits-all solution, but some savvy and forward-thinking radiology stakeholders are putting the pieces of the puzzle together.

Certification pathways

Center for Diagnostic Imaging (CDI), a Minneapolis-based outpatient imaging provider with 51 owned clinics and nine managed centers, started considering MU nearly two years ago in combination with a proposed clinical decision support project.

As CIO Steve Fischer and his team consider the certification process, a few certainties stand out. The practice’s billing system has been certified, and its RIS vendor has started the certification process, allowing CDI to tick off a handful of measures such as patient demographics and medication lists.