MU Educational Session at RSNA 2015

In this month’s post, we take a look at an upcoming educational session at RSNA 2015.

In less than 2 weeks, nearly 60,000 radiology professionals from around the world will converge on Chicago to witness the latest discoveries, techniques and innovations for diagnostic imaging.

If you’re heading to the windy city later this month, don’t miss this educational session dedicated to meaningful use in radiology.

Meaningful Use for Radiology: Pros and Cons
Tuesday 8:30-10:00 AM | RC354 | S404CD

AMA PRA Category 1 Credits™: 1.50 | ARRT Category A+ Credits: 1.50


  • Ramin Khorasani, MD (Moderator/Presenter)
  • Alberto F. Goldszal, PhD, MBA (Presenter)
  • Keith D. Hentel, MD, MS (Presenter)
  • James Whitfill, MD (Presenter)

Learning Objectives:

  • Understand how a radiology practice that was a later adopter of meeting meaningful use criteria has achieved successful results for two years running.
  • Learn about CMS MU audits and the audit process.
  • Learn about challenges for meaningful use stage 2 and radiology.

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MU in Action: Meaningful Use for Radiology

In this month’s post, we highlight an interview conducted with Dr. Wells Mangrum, MU program lead at a small radiology practice in Wisconsin.

Medical X-Ray Consultants is a small practice of 12 radiologists in Eau Claire Wisconsin that services a variety of hospitals across northwest Wisconsin and eastern Minnesota. As part of their commitment to quality, participating in the Meaningful Use program was an important part of their strategic plan.

What was the core challenge you faced in implementing a Meaningful Use program?

Our small radiology group covers many hospitals and each provider organization has a different Electronic Health Record (EHR). Many of these hospital EHRs are certified for Meaningful Use (MU) on the inpatient side, but not outpatient. Accordingly, our radiology group found ourselves in a dilemma as to how to meet MU requirements in the outpatient setting. We also needed to balance the workflow impact of leveraging all the various EHR solutions verses finding a more streamlined solution.

What solution did you find?

After exploring all available options, we found ImagingElements, a radiology-centric EHR provider that offers a complete certified solution to meet outpatient MU requirements. They offered a platform and capability that resolved our dilemma—we use their web-based platform to record outpatient information in a manner that satisfies Meaningful Use requirements. One of ImagingElements unique capabilities is their “denominator reduction” approach. This dramatically reduces our data collection workload and focuses our Meaningful Use efforts towards the specific encounters that matter.

Were there any challenges along the way?

Capturing and recording encounter data was our biggest hurdle. We first considered creating an interface between our hospitals and ImagingElements, but this proved to be challenging given the number of hospitals we cover and the limited technical support that we could obtain from each. The ideal solution then presented itself; our billing company, Cvikota, stepped in to act as an intermediary. They offered to collect the necessary information from the many hospitals—indeed they were already collecting much of the information for billing purpose—and then electronically send the information to ImagingElements. This greatly simplified things by only requiring us to create one new interface, an interface between our billing office and ImagingElements. In the end, this has worked extremely well and frankly was easy to do once we found the right team of ImagingElements and our billing office. I highly recommend that other radiology groups in our situation follow a similar course of action to achieve Meaningful Use.

Anything else to add?

Yes. ImagingElements was not just another company selling a certified MU product. They also provided expert guidance on how the complex rules of the Meaningful Use program apply to radiology practices. This additional consultative element was crucial to our success. They have put together a comprehensive set of policies that have been an excellent step-by-step guide for us to follow to ensure that we meet the requirements of this government program.

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Imaging Provider Perspectives

In this month’s post, we take a look at responses to one of the questions posed in the interview chapters of The Radiologist’s Guide to Meaningful Use: A step-by-step approach to the Stage 1 CMS EHR Incentive Programs.

What have you and your organization done to educate yourselves on the fundamentals of meaningful use?

Response: Dr. Keith J. Dreyer, Massachusetts General Hospital

Our CIO introduced me to meaningful use during a presentation in late 2009. I asked if there was a plan to include the radiology department and quickly learned that our team needed to educate ourselves on the ins and outs of the program. We reviewed the literature, examined the timetables, analyzed the standards, implementation specifications, and certification criteria, and assessed the reporting requirements. We also used many of the resources on the CMS EHR Incentive Programs website— fact sheets, summaries, and online video tutorials—to better understand meaningful use and build our strategy.

Response: Dr. Alberto Goldszal, University Radiology Group 

First, let me say that it’s important to start educating yourself now if you haven’t done so already. To educate ourselves on meaningful use we used three primary sources. First, we looked at the basics and general requirements of the program. We attended conferences and lectures and read through various publications. We also relied heavily on word-of-mouth. A second source that we tapped for information was We used this website to better understand the layers under the program as they relate to the medical imaging community—this was invaluable. Lastly, we learned a lot from our RIS vendor, who understood the incentive programs and engaged us early on in the process.

Response: Dr. David Mendelson, Mount Sinai Medical Center

As soon as the ARRA of 2009 and HITECH Act were announced, our organization immediately established a cross-functional committee at the clinical level and began analyzing all of the relevant federal documents that were available at the time. We reviewed those documents line-by-line and distilled that information into a summary document that outlined things we had to do and questions we needed answered—it essentially became a working document to guide us.

As soon as the timelines were announced, we began planning on both the inpatient and ambulatory sides. We conducted a financial analysis that included billing data for Medicare and Medicaid and identified whom on the clinical staff, and later radiology staff, would be eligible for incentive opportunities.

Specific to radiology, we are staying apprised of the program by using resources like and medical society websites, speaking with colleagues about their strategies, and closely monitoring changes and clarifications to the regulations.

We really are focused on understanding the financial implications, who is eligible, who is not eligible, what our vendors are doing, and how they will support our strategy. We’re also evaluating different approaches and looking at our RIS, our hospital EHR, as well as other certificated technology that we might be able to leverage to achieve meaningful use.

Response: Steven Fischer, Center for Diagnostic Imaging

The most valuable information came directly from CMS—including details about incentive payouts, eligibility determination, and general guidance and clarification. We also reviewed the regulations, certification processes and test scripts, and looked at trade magazines as well as a variety of online resources. We basically scoured all of the available content to find whatever information we could. 

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Imaging Provider Perspectives

In this month’s post, we take a look at responses to one of the questions posed in the interview chapters of The Radiologist’s Guide to Meaningful Use: A step-by-step approach to the Stage 1 CMS EHR Incentive Programs.

Any final thoughts or advice you would offer to other imaging providers that are developing their strategies for meaningful use? Any thoughts or hopes for future stages of the program?

Response: Dr. Keith J. Dreyer, Massachusetts General Hospital

It helps a lot to understand the fundamentals of the program and run an analysis for your imaging practice. It’s well known that most radiologists are eligible, so the question really becomes whether or not you want to participate. Next, you need to review your measure requirements and make sure that your IT vendors are prepared to support your strategy. Lastly, I would encourage you to continue reading articles, visiting the official program websites, attending tradeshows, participating in meaningful use lectures, and doing all you can to stay on top of meaningful use as it applies to radiology.

As for future stages, the hope would be that the challenges for medical specialists—lack of direct clinical relevance, access to technology and data, and inflexible requirements—would be better addressed. The incorporation of imaging data as part of meaningful use and specialty-specific requirements would also increase the relevance of the program.

Response: Dr. Alberto Goldszal, University Radiology Group

Start early. If you haven’t started yet, you really need to hustle. The key here is to be prepared and work with a certified technology provider that can support your strategy. You need to plan your work and work your plan.

Achieving meaningful use is doable, especially for radiology. We have developed, implemented, and adopted clinical information systems for more than twenty years and can conquer this challenge too. But, it needs to be an organized effort on the part of internal and external parties to be successful. If your radiology IT vendors are not ready, you will have difficult decisions to make.

You have to go through the growing pains. You must crawl and walk before you can run. And we are all in the crawling stage, which for this program means putting the data in a structured format. Once we do that, we can enable communication standards and begin to extract additional value out of this collective effort.

Some may believe that the cost of this program outweighs the benefits or that we are never going to get there. These are valid concerns, but if you take the positive out of it, there is no reason to believe that it’s not the right direction to go. The program is evolving and our profession will evolve with it.

Response: Dr. David Mendelson, Mount Sinai Medical Center

If you have any belief that you are going to be involved with these programs, you need to have at least one point person from attending staff and one from finance actively engaged and monitoring program changes. It’s a dynamic topic and you can’t learn it overnight. You really need to review all available material, look at everything you have to do, and stay on top of program requirements. Bottom line is not to be naïve about it.

While the radiology community acknowledges the public health benefits of the programs, with respect to current and future stages, there are better ways to improve the quality of care by radiologists and the imaging profession in general. There should really be meaningful use measures that are specific to medical specialties. To provide a “real” contribution to medical workflow, future stages of the program should provision such efforts as clinical decision support to ensure appropriate imaging, encourage image sharing to reduce unnecessary exams, and promote the tracking and monitoring of radiation dosing. While there might be difficulties with implementing all of this, it’s well worth the effort.

Response: Steven Fischer, Center for Diagnostic Imaging

To be successful, it’s better to get started sooner than later. You need to decide exactly what you are going to do and how you are going to get there. As for future stages, it would be really nice to see an increased focus on technology and processes that are more representative of the roles and responsibilities of medical specialists. Technology, such as decision support for diagnostic image ordering appropriateness, will have a greater impact on radiologists, while also improving the overall patient care workflow.

Ready to learn more, buy the book today!

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