RSNA: Busting the meaningful use myth
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With the recent passage of the U.S. Federal Health IT rulings for meaningful use, it is estimated that more than 90 percent of all U.S. radiologists will be eligible for substantial Centers for Medicare & Medicaid Services' (CMS) incentives. Collectively, these incentives total more than $1 billion for radiologists. More specifically, for large practices, these incentives will approach $10 million. For example, the potential financial impact for Massachusetts General Hospital (MGH) of Boston radiologists is approximately $8 million, shared Keith J. Dreyer, MD, vice chairman of radiology at MGH.
Eligibility for meaningful use will depend upon the individual radiologist’s practice scenario but, regardless of the practice setting, each radiologist will be required to purchase and utilize certified technology that meets the 25 meaningful use measures and objectives. Some of this technology will come from existing infrastructure (including RIS, PACS and reporting systems) and others will come from new purchases (including decision support, data mining, image sharing and patient portals).
Health IT vendors may benefit from an expanded market if they take advantage of the new opportunity and create and market products to help radiologists meet meaningful use.
Making a match Radiology and meaningful use are not well-aligned, admitted Avrin. However, there is a fit. Dreyer offered some insights. He explained that radiology IT systems such as RIS and PACS are EHRs, according to the government. As such, they are eligible for modular certification of 1 to 34 measures.
Dreyer hazarded rough estimates of the number of meaningful use measures and criteria radiology products might meet. (Measures apply to eligible providers, while criteria apply to systems that vendors must certify.) These are:
- RIS could cover 5 to 15 measures and 13 to 23 criteria;
- PACS could cover 0 to 3 measures and 9 to 12 criteria;
- Reporting systems could cover 2 to 5 measures and 10 to 13 criteria;
- Image sharing/patient portals could cover 1 to 3 measures and 9 to 12 criteria; and
- Decision support could cover one measure and 9 criteria.
The challenge for vendors, Avrin explained, is to align product features with meaningful use, certify the system with an authorized certification body and market the system.
Radiologists face multiple meaningful use challenges, noted Dreyer. Currently, no existing radiology products are certified. (On the show floor a few vendors did express intentions to certify and develop products.) Plus, when imaging technologies do achieve certification, it is likely that they will be certified as modular products rather than a full EHR. The practice then must undertake the challenging process of cobbling together a multi-modular system to meet all meaningful use criteria. Finally, the radiology group needs to determine if it is meeting meaningful use goals.
Despite the challenges, Dreyer is seeing momentum among radiology practices. “This is a chance to increase revenue at a time when radiology revenues are decreasing,” he explained. Dreyer said more practices are turning to the www.radmu.org site to learn about meaningful use, ask questions and access a widget that analyzes eligibility and determine measures and certification criteria.
Looking ahead
The motivators to engage radiologists in meaningful use will continue, said Dreyer, as groups build understanding of incentives and penalties. Plus, commercial payors are exploring meaningful use requirements and possible sanctions for practices that fail to comply.
As radiologists begin to grapple with the concept of meaningful use and stage 1 requirements, the government and professional society stakeholders are beginning to decide and discuss stage 2 and stage 3 requirements. Dreyer offered an educated guess regarding targets relevant to radiologists and suggested that the focus could include computerized physician order entry and clinical decision support, image management and sharing, communication management and radiation dose monitoring.