Report from SIIM: Ability to share images, reports could enhance radiology’s role in federal stimulus

June 5, 2009

Capitalizing on radiology’s experience in report sharing could provide a pathway for electronic medical records development, a goal heavily funded with federal stimulus money. A panel Thursday at the Society for Imaging Informatics in Medicine meeting discussed this opening as one way to define radiology’s role in the massive spending effort to stimulate the economy.

Capitalizing on radiology's experience in report sharing could provide a pathway for electronic medical records development, a goal heavily funded with federal stimulus money. A panel Thursday at the Society for Imaging Informatics in Medicine meeting discussed this opening as one way to define radiology's role in the massive spending effort to stimulate the economy.

"I'm wondering if there's an undefined opportunity for the radiology community to work with the government to capture dollars for our specialty to substantiate interoperability," said Dr. David S. Mendelson, director of radiology informatics at Mt. Sinai Medical Center in New York City. "My guess is that we're better positioned to take leadership for the sharing of images and reports than almost any other domain sitting out there."

Mendelson's comments came during a discussion of economic stimulus package funding opportunities. More than $19 billion has been earmarked to promote the adoption of electronic medical records.

Two other hospital-based specialties, anesthesiology and emergency care, were specifically excluded from economic stimulus funding under the legislation approved earlier this year, but radiology was not, Mendelson said.

Since radiologists are relatively well paid, however, it might be politically unwise for them to make a direct bid for a share of the roughly $44,000 per physician the government seems ready to pay for EMR adoption.

"I think we need to displace greed," Mendelson said. "Maybe a radiology practice doesn't get $44,000, but if we look at what it would really cost to reproduce systems in our offices that would facilitate secure interoperability, we might be well positioned to take leadership on how you share healthcare data. There's probably a sum of money that's reasonable to expect us to spend on that, and maybe we can get the government to say that's the amount of money that should be invested in radiology."

Interoperability is a theme of this year's SIIM meeting. So far, the society hasn't set a strategy for introducing imaging informatics into discussions about EMR adoption, said SIIM chair Dr. Bradley Erickson, a member of the panel. SIIM does have a history of supporting the Integrating the Healthcare Enterprise project and a track record for promoting interoperability.

These facts could become apparent as policymakers begin to address the many questions about how the EMR will work, but lobbying directly for a role in EMR adoption would probably be ineffective, he said.

Erickson agreed, however, that interoperability and data sharing are strengths for radiology and a potential focus for a stimulus effort.

Not all of the discussion was positive. In some settings, facilities are reluctant to share images they have or to seek images from other providers, preferring to collect new images as well as the fees for them, members of the audience said.

"I'm pretty sure that the ability to diminish redundant, unnecessary studies, from a cost perspective and a quality perspective in terms of dose, is going to be a major driver that is going to have all of radiology moving toward interoperability," Mendelson said.

Deciding how you build the rules and regulations to distribute payments for shared images and who pays the penalty when an unnecessary imaging study is repeated would require much discussion, he said.