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Meaningful Use stage 3: ACR shares comments

by Nancy Ryerson, Staff Writer | January 22, 2013
The American College of Radiology weighed in on Meaningful Use stage 3 proposed objectives, releasing a statement that called for more flexible requirements for specialists such as radiologists. The HIT Policy Committee plans to finalize its MU stage 3 requirements by May of this year, but the ACR also recommended it hold off until providers can give feedback on stage 2 requirements, finalized in September 2012.

More than 90 percent of radiologists qualify for the Medicare version of the EHR incentive program. For those practitioners and other specialists, the ACR recommends optional/substitute MU pathways, as some items may be clinically irrelevant for non-primary care physicians. Another option is to make the complete list of MU initiatives into a "menu" rather than delineating optional and "core" objectives, allowing for more flexibility for all practitioners, the statement said.

In addition to making general recommendations, the ACR also commented on specific stipulations of MU stage 3. Its CPOE recommendation requires that 60 percent of medication, laboratory and radiology orders created by the physician during the EHR reporting period be recorded using CPOE, up from 30 percent for radiology and lab orders. The ACR suggests that those orders also include integrated clinical decision support such as the ACR Appropriateness Criteria, and the criteria should assign numeric appropriateness ratings to different imaging procedures, allowing providers to determine whether the test is necessary, including those guidelines that would reduce unnecessary radiation exposure and reduce health care costs, the statement says.

One rule ACR agreed with regarded making imaging results accessible through an EHR. While a "menu" choice in stage 2, it was proposed as a "core" objective for stage 3. The ACR also agreed that patients should be able to view imaging results and dose information from home through patient EHR portals that are required under MU, acknowledging that the technology exists and would help patients be aware of their lifetime radiation dose.

The ACR statement concluded by encouraging HITPC to seek out more feedback from specialty societies to make sure initiatives make sense for radiologists and other non-primary care physicians.

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