When Congress passed the stimulus legislation last year, with its $19 billion appropriation to help boost electronic health record adoption in the U.S., it was considered mildly interesting to radiologists. The specialty, after all, has been leading the way toward digitizing its care process since the 1990s.
But in January, when CMS outlined its initial plans for meaningful use, the mechanism whereby physicians can prove the value of their investments in electronic health record technology and thus become eligible for the incentive payments authorized in the stimulus act, radiology’s attitude turned to dismay. Radiologists had been left out of the picture.
But then CMS opened up the rules for comments, and organized radiology took advantage of the opportunity, showing CMS how it could define meaningful use so that the concept, and its accompanying benefits, could reasonably be achieved by all radiologists. The result: new rules allow nine out of 10 radiologists to qualify for the meaningful use incentives.
A lot of radiologists have been less than satisfied with the Obama administration’s healthcare reform and stimulus efforts, and certainly not all of their complaints have been misdirected.
The bigger picture, though, is that through its stimulus/meaningful use/EHR program the government is making a big investment in an attempt to improve the quality of medical care in the U.S. and that this investment is going to set directions in medicine well into the future. Radiologists can get on board with this program or they can stay out. I expect most will conclude they are better off getting involved.
The benefits of doing so are considerable.
• Radiologists have long argued that medical imaging is playing a growing role in patient care. Complaints about overutilization of imaging notwithstanding, we know that when imaging is used appropriately, it answers crucial questions quickly and accurately. Ensuring that imaging is included in the EHR assures that radiology's role is recognized and valued.
• An image-enabled EHR will eventually help solve three big problems in radiology: lack of a patient history, lack of priors, and unnecessary repeat studies.
• Involvement in the meaningful use program leverages radiology’s already considerable knowledge in the digital management of medical data. Facilities that hope to establish meaningful use programs will often look to radiologists for guidance. This, in turn, could be an opportunity to strengthen the specialty's presence.
Add in the $44,000 per physician incentive payment, and the potential penalties for those who fail to produce under the program, and there are plenty of reasons to become involved.
As for doing so, we've provided a roadmap in our cover story (“Meaningful use: the government’s billion dollar gift to radiologists,” page 18). It explains a bit of the history, the economic consequences, time frames, what you’ll need to do to qualify, and more. An important part of this will be engaging your facilities and your IT vendors in meaningful use discussions. You can use some of your existing IT systems to help you qualify, but other aspects will require new data elements that will need to be certified and come from vendors.
As the article's author, Dr. Keith Dreyer, notes, there is considerable pressure for all physicians, including specialists such as radiologists, to become meaningful users. But your participation will benefit the profession of radiology and the quality of care. The door was closed at the beginning of this year. Now it is open and it is time for radiology to step through.