The Future of Meaningful Use in Radiology

Through the implementation of the Health Information Technology and Economic Health Act of 2009 (HITECH), funds were created to provide a nationwide interoperable health information infrastructure that promotes the electronic use and exchange of information, Alberto Goldszal, MBA, PhD, said at RSNA2015. All while incentivizing eligible medical providers who participate in Meaningful Use-certified EHR technology.

With its inception in 2011, Meaningful Use (MU) is approaching its five-year mark and continues to aim to provide complete information with better access and patient empowerment.

 “Meaningful use of EHR technology should result in health care that is patient centered, evidence-based, prevention oriented, efficient, and equitable,” Goldszal said.

Benefits of using MU include cloud sharing of data, reduced risk for radiologists by having an enhanced RIS, and modest financial gains if your institution has a certified EHR.

With that said, MU has had many challenges within its first two stages, including late adoption by physicians, difficulty integrating with IT that is not certified, costs outweighing revenues, and arduous auditing processes that “CMS has reported resulted in up to 20% of EP’s failing audits during Stage 1,” Goldszal said.

When deciding whether to qualify for MU, Keith Hentel, MD, MS, Weill Cornell Medical College, took into account potential incentives to become an early adopter, and while Hentel noted that “63 clinical faculty members were qualified to use it with a potential incentive of over $2,000,000,” the practice discovered many barriers that “tempered the desire to implement MU.”  Such barriers included not having a certified health IT that integrated radiology IT with the EHR, an EHR that was only being utilized as a review mechanism, and a poor ROI.

At Brigham and Women’s Hospital, Ramin Khorasani, MD, MPH's group was able to successfully implement MU, largely because of access to a certified EHR system and an institutionalized approach. They trained multidisciplinary teams on MU workflow, allowed for change management training, and used MU dollars for incentivized compliance and the building of useful clinical tools.

Khorasani contends that “qualifying for MU has been challenging for many radiology practices in the short term,” and there is a need for the next generation EHRs to make the process more attainable. Penalties that started in 2015 will make it important to qualify for MU or exemptions in the future.

MU has undergone two stages thus far, and as we move towards stage three, the structure will have “slightly higher thresholds from stage 2, while remaining similar in structure and measurement,” Goldszal said.

 Another new feature will be the inclusion of a Merit Based Incentive Payment System (MIPS), which will begin in 2019 and help to consolidate current pay for performance programs including MU, PQRS, and value-based care measures. According to Goldszal, institutions will need to focus on “developing a strong foundation and strategic plan for value-based reimbursement including MU in order to avoid penalties and be on the bonus side of MIPS in the future.”[[{"type":"media","view_mode":"media_crop","fid":"43792","attributes":{"alt":"","class":"media-image","id":"media_crop_4735207829533","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4853","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","title":" ","typeof":"foaf:Image"}}]]