RSNA: MUfacts and fictions for radiology

CHICAGO--Despite early assumptions that meaningful use (MU) targeted only primary care, the Centers for Medicare & Medicaid Services (CMS) has paid nearly $1 billion to eligible providers and less than half of that amount has been distributed to primary care physicians, Keith J. Dreyer, DO, PhD, vice chairman of radiology at Massachusetts General Hospital in Boston, said during a Nov. 29 session at the 97th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).

Dreyer shared a host of other facts and fictions, dispelling some incorrect assumptions and providing a foundation for practices uncertain about what the program means for their business. The good news is that more than 90 percent of radiologists qualify for meaningful use incentives, which can reach $44,000 per physician. However, it is a one-size-fits-all model and was designed for primary, not specialty, care.

The framework of MU is clear. It consists of three stages. The first stage emphasizes capturing and sharing data. Stage 2, slated for 2013 to 2014, adds clinical decision support. And Stage 3, scheduled to begin in 2015, stresses improved outcomes.

KLAS, a market research firm in Orem, Utah and RSNA, recently published a report “Radiologists’ Take on Meaningful Use.” The survey of more than 200 radiologists showed that 28 percent are planning to qualify for MU incentives, 27 percent are considering it, 35 percent don’t know and 10 percent are not planning to qualify for incentives. Meanwhile, on a scale of 1 to 5, with 5 equating with very high familiarity with MU, 25 percent of radiologists scored at 1 and 2 respectively, with another 28 percent at 3.

“The survey showed folks in radiology are making decisions without a lot of knowledge and information,” said Dreyer.

One of the primary challenges with MU is that every practice is unique; the path to MU will likely differ for every practice. One basic measure divides radiology groups into hospital-based and non-hospital based practices.

Hospital-based practices may face an additional challenge, explained Dreyer, as the hospital may have selected a certified EMR to use to comply with MU. However, that decision was likely made without the input of the radiology group and is unlikely to fit into radiologists’ workflow.

The path may be slightly less onerous for non-hospital based practices that can independently invest in a certified RIS as the primary path to MU. (RIS, rather than an EHR, is typically the optimal system for radiology providers aiming for MU incentives.)

Dreyer explained that there is no formula that he could dispense to struggling practices. Instead, practices need to know what questions to ask vendors whose products will serve as the cornerstone of the MU plan. Key questions include:

• Is the product certified?
• Is certification complete or modular?
• Which criteria is the product certified for?
• If the RIS is not certified, or is modularly certified, what are the future plans?

Dreyer issued a few cautions. According to the Office of the National Coordinator for Health IT, practices need to own systems that possess all certification criteria even if they don’t report on all criteria. That is, the practice must own technology that covers evens measures that they are excluded from. He also predicted, “Very soon all standalone RIS will require complete certification. Modular won’t suffice. RIS is becoming the imaging EHR.”

Are RIS vendors ready?
The RSNA-KLAS survey showed varying levels of preparation among RIS vendors. One-third possess complete certification, another one-third possess modular certification, 18 percent are in process and 12 percent have no plans to pursue meaningful use certification.

Dreyer foresees a different landscape in 2012, and said, “Every RIS vendor will have complete certification one year from now.”