The AMDIS Connection: Meaningful Use in Radiology: Potential for Clinical Transformation
The consideration of radiologists as eligible providers under the provisions of the federal HITECH Act has been the subject of much consideration given the availability of an estimated $1.5 billion in potential incentive payments to radiologists. However, the potential transformation of radiology into a specialty that utilizes an EHR as a core clinical application has much greater clinical implications both for the CMIOs, as well as radiologists.
The requirement that all eligible providers, including radiologists, have access to EHRs or face reimbursement penalties beginning in 2015 is well documented. However, the opportunity that this clinical transformation provides radiologists cannot be overstated. Radiologists frequently lament the detrimental effect on the sensitivity and specificity of imaging interpretations attributable to the lack of pertinent clinical information that often accompany imaging requisitions, which is a common topic in radiology literature.
As radiologists acquire access to the same clinical information as their clinical colleagues using an ordering decision, the oft-denigrated radiologist's phrase: "clinical correlation is suggested" should become as passé as a film-based clinical practice.
With the potential to access the entirety of information regarding a patient's clinical presentation, radiologists will begin to transform their reporting processes to incorporate clinical laboratory information and other ancillary data. Ideally, the radiologist should have instant access to the clinical data available from a referring clinician's outpatient EMR.
Historically, requests for access to clinical information were impossible because that information was often recorded in a paper-based system. But here's an interesting fact: If a clinician is utilizing a certified EHR in a meaningful way, then certified problem lists, allergy information, clinical laboratory results and clinical summaries are available, not only for the patient, but also to radiologists and other clinicians.
CMIOs should actively look for ways to engage their radiology colleagues to assist in the overall success of the EHR implementation and ongoing clinical process improvements. While traditionally radiology services have considered the PACS and radiology information systems (RIS) as core operational systems, given the requirements of meaningful use, EHRs also will become a key radiology clinical IT system. Many ongoing clinical processes in radiology, such as allergy checking, medication lists and vital signs, can be leveraged and included in the EHR initiative. While RIS and PACS may evolve to accommodate this clinical information, a worthwhile strategy for the CMIO to consider is the increased scope of the EHR implementation to include radiology. By including radiology in the overall scope of the EHR implementations, radiologists can contribute to the overall success, as well as an overall positive impact in clinical outcomes.
CMIOs and their radiologist colleagues should appreciate the common goals in the implementation of advanced clinical reporting systems. In this context, our efforts to implement structured clinical data reporting systems will be beneficial through a synergistic approach to clinical reporting.
The requirement that all eligible providers, including radiologists, have access to EHRs or face reimbursement penalties beginning in 2015 is well documented. However, the opportunity that this clinical transformation provides radiologists cannot be overstated. Radiologists frequently lament the detrimental effect on the sensitivity and specificity of imaging interpretations attributable to the lack of pertinent clinical information that often accompany imaging requisitions, which is a common topic in radiology literature.
As radiologists acquire access to the same clinical information as their clinical colleagues using an ordering decision, the oft-denigrated radiologist's phrase: "clinical correlation is suggested" should become as passé as a film-based clinical practice.
Fundamental transformation
For radiologists, "Meaningful Use of a Certified Ambulatory EHR" purports a greater opportunity to fundamentally transform the role of radiologists from interpreters of images to imaging clinical consultants. Computerized provider order entry (CPOE) systems with "appropriateness" criteria are only the beginning of this possible transformation.With the potential to access the entirety of information regarding a patient's clinical presentation, radiologists will begin to transform their reporting processes to incorporate clinical laboratory information and other ancillary data. Ideally, the radiologist should have instant access to the clinical data available from a referring clinician's outpatient EMR.
Historically, requests for access to clinical information were impossible because that information was often recorded in a paper-based system. But here's an interesting fact: If a clinician is utilizing a certified EHR in a meaningful way, then certified problem lists, allergy information, clinical laboratory results and clinical summaries are available, not only for the patient, but also to radiologists and other clinicians.
CMIOs should actively look for ways to engage their radiology colleagues to assist in the overall success of the EHR implementation and ongoing clinical process improvements. While traditionally radiology services have considered the PACS and radiology information systems (RIS) as core operational systems, given the requirements of meaningful use, EHRs also will become a key radiology clinical IT system. Many ongoing clinical processes in radiology, such as allergy checking, medication lists and vital signs, can be leveraged and included in the EHR initiative. While RIS and PACS may evolve to accommodate this clinical information, a worthwhile strategy for the CMIO to consider is the increased scope of the EHR implementation to include radiology. By including radiology in the overall scope of the EHR implementations, radiologists can contribute to the overall success, as well as an overall positive impact in clinical outcomes.
CMIO support
Future meaningful use stages will likely include an increased emphasis on structured reporting for radiologists and other specialists.CMIOs and their radiologist colleagues should appreciate the common goals in the implementation of advanced clinical reporting systems. In this context, our efforts to implement structured clinical data reporting systems will be beneficial through a synergistic approach to clinical reporting.