Special report: Fitting radiology into the MU puzzle

May 18, 2011
by Olga Deshchenko, DOTmed News Reporter
This report originally appeared in the May 2011 issue of DOTmed Business News

In late March, Keith J. Dreyer, the chair of the American College of Radiology’s IT and Informatics Committee-Government Relations Subcommittee, sat down with health officials to reiterate the interests of imaging professionals in meaningful use.

Radiologists have the opportunity to reap the $44,000 stimulus as part of the Medicare and Medicaid EHR Incentive Programs, if they successfully demonstrate MU before 2015. But before then, government officials and radiologists hope to find common ground on what it actually means for the imaging profession.

Dr. Bradley Erickson, a professor of radiology with the Mayo Clinic in Rochester, Minn., says opinions on whether radiologists can successfully meet the specified MU criteria differ.

For instance, a certain regulation requires doctors who see pediatric patients to document where they are on the growth chart. As a neuroradiologist, Erickson can read a child’s head CT scan but may not be able to easily note the patient’s height. “And even if I do document it, I’m talking about the head, so it’s not particularly easy for me to paste in a growth chart,” he says.

At first, lawmakers seemed to understand such particular challenges and agreed it’s reasonable to have exclusions to the criteria based on relevance for the physician. “Unfortunately, in one of the recent revisions, those exceptions have been called into question,” says Erickson. “There may not be the flexibility that we were originally led to believe.”

“I think there are times when radiologists have been optimistic that they can qualify and other times when they are less optimistic, just because changes in the rules or the interpretations of the rules can have a dramatic impact,” he says.

Hospital & office radiologists
For many radiologists who are a part of a hospital or a larger health system, meaningful use can be an exercise in patience. Within major facilities, the priority in the process is centered on the doctor majority, since there are many more non-radiologists who need to demonstrate MU to avoid penalties and take advantage of incentives.

For the Mayo Clinic, the multi-million-dollar EHR effort has not been without challenges. One issue is meeting the reporting requirements of both federal and state regulations. Differences in data collection and reporting for varying levels of government “meant that we had to collect that data separately,” says Erickson.

Although it may seem like a difficult process, Erickson believes the overarching goal of the MU initiative will greatly benefit radiologists. “It’s likely that radiologists will be able to do a better job of practicing radiology if they do have access to all that EMR information,” he says.
Meaningful advice

To keep up with MU, Erickson recommends developing a plan and establishing a set of priorities. Like at the Mayo Clinic, it’s important for hospitals to be mindful of groups like radiology throughout the process. Recognizing the varying needs of specialties will help develop solutions that could then be generalized across the whole institution.

Appointing a person or a group to keep track of the evolving MU regulations and to work with local government representatives is also vital. “It’s not so much that the legislation is changing but the rules and the interpretation of the rules are changing,” says Erickson. “I think one important activity is just to have a way to keep your finger on the pulse of what’s happening.”
Although the road to MU has its obstacles, advocates of health IT are confident the transition will improve the process of care. And for radiologists, finding their way to MU will mean striking a balance between integration into the larger EHR and the maintenance of flexibilities in workflows that characterize efficiency in radiology.

Learn more about MU at SIIM 2011:
"MU for Me and You" Hot Topic Session
Chaired by Dr. Bradley Erickson
Thursday, June 2
1:15 pm – 2:45 pm
Potomac Ballroom C