The last mile of meaningful use — value

In this months post, we take a look at an article written by, Bob Cooke, Vice President, Marketing, National Decision Support Company.

The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) for Health IT took a leap forward with their recent releases of the Stage 3 Proposed Rule and HIT certification criteria, respectively. At the highest level, a key requirement derived from these proposed program updates is that providers will need to comply with a revised set of requirements in order to receive future value-based reimbursements.

The Stage 3 Proposed Rule focuses on the exchange of data across episodes of care as opposed to whether or not providers “see patients,” “have office visits,” or fall under others terms that don’t really apply to radiologists. It’s not that radiologists don’t conduct “office visits,” or “see patients,” it’s just that to apply these definitions against a radiologist’s compliance with Meaningful Use, and more importantly, extracting value from participation by imaging is practically impossible. Collecting this data is not enough for radiology.

Take smoking status for example, a fairly simple piece of data. For most of the radiologists in the country, this simple piece of data is not available as part of the interpretation process. Collecting it when you see a patient is one thing, but for a radiologist to see it when they interpret an exam for the patient, it can mean everything, as Brigham and Women’s Hospital found out when a jury awarded a patient $16.7 million for a missed cancer diagnosis on a simple CXR for a patient. It turns out the radiologist did not have access to the patients history, which included a family history of lung cancer and a 30 year habit. The exchange of this kind of data is critical to healthcare providers and consumers alike.

Exchanging data across episodes of care (e.g. a radiology encounter) has tremendous benefits to radiology as it enables practices to capture relevant clinical information and apply it towards value-based workflows using widely available, and established, implementation standards. Furthermore, this same exchange mechanism transports coded radiology results, updated medications (for interventional exams) and vitals as appropriate, as the Stage 3 Proposed Rule formally defines the radiology report as part of the Clinical Document Architecture (CDA).

Another key component of Meaningful Use is Clinical Decision Support (CDS). And, the Stage 3 Proposed Rule encompasses the implementation of CDS for recording clinical quality measures and to align incentives with the Physician Quality Reporting System (PQRS). Furthermore, the Protecting Access to Medicare Act of 2014 (PAMA) requires physicians to consult CDS in order to receive payments for Medicare claims.

All in all, radiology has an opportunity to leverage these proposed program updates to deeply embed themselves into the patient care cycle and measure and improve their value in delivering more cost effective and higher quality patient care.

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ACR Comments on ONC’s Proposed Rule to Establish Voluntary 2015 Edition EHR Certification Criteria

In this month’s post, we take a look at the ACR’s comments on the ONC’s Proposed Rule to establish voluntary 2015 Edition EHR Certification Criteria.

Last month, the American College of Radiology (ACR) submitted comments to the HHS Office of the National Coordinator for HIT (ONC) regarding the agency’s proposed rule to establish voluntary 2015 Edition EHR certification criteria. The 2015 Edition would be an optional alternative to the 2014 Edition criteria for the certification of products used by participants in the Medicare/Medicaid EHR Incentive Program (“meaningful use”). Additionally, the proposed rule included several questions intended to inform the ONC’s future 2017 Edition rulemaking.

he ONC’s two previous EHR certification criteria rulemakings took about 7 to 8 months between the publication dates of the proposed rules and final rules. While it is possible ONC could turn the 2015 Edition final rule around more quickly (perhaps even as early as August), it is unclear how the separate and conflicting 2017 Edition rulemaking will impact the timing.

Links to resources:

For more information, please visit the Radiology and HIT Blog.

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MU Takes the Stage at RSNA 2013

In this month’s post, we take a look at news and industry updates from RSNA 2013.

Meaningful use is one of the most discussed topics across all health care specialties—and radiology is no exception. The challenges that the imaging community faces, and experiences of those that have already tackled this government program, were shared at the recent Radiological Society of North America annual conference.

RSNA 2013 offered a number of educational tracks and sessions dedicated to the subject. From information packed sessions for radiology IT providers, to discussions with leaders in the field, there was something for everyone impacted by the CMS EHR Incentive Programs. What’s more, this year’s conference featured dozens of new solutions designed for, and used for attestation by, radiology professionals.

Furthermore, a number of feature articles have been published over the past 2 weeks that focus on the topic of meaningful use and provide an excellent recap of the sessions and discussions that took place at the conference.

MU News from RSNA 2013

  • Radiologists Share Diverse Meaningful Use Experiences –Read more…
  • Should Hospital-based Radiologists Pursue Meaningful Use? – Read more…
  • Some Radiologists Embrace Meaningful Use, Others Wait –Read more…
  • Take a Long View of MU –Read more…
  • New RIS workflows making EHRs look low-tech – Read more…

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2013: Radiology meets Meaningful Use

In this month’s post, we take a look at recent results from a meaningful use survey conducted via, and

How many radiologists are participating in meaningful use? How many plan to participate? Are any imaging groups taking advantage of the temporary hardship exceptions? These are just a few of the many questions you might have related to the CMS EHR Incentive Programs. While many of these questions may remain unanswered, a recent survey reveals some interesting trends.

The following data was collected from survey respondents via,, and between December 1, 2012 and January 31, 2013.

72% of radiology professionals surveyed are participating in the CMS EHR Incentive Programs

4 out of 10 have attested and received incentive payments, of those, 1 out of 4 have been audited

58% have more than 50% of their outpatient encounters at location(s) with CEHRT

8 out of 10 can work with managers of their CEHRT to be included on MU threshold dashboards, of those that can’t work with CEHRT managers, 95% still wish to participate

Of the 1/3 that are not currently participating in meaningful use, more than 91% are interested in doing so and 2/3 wish to be temporarily exempted from future penalties

Where do you stand with Meaningful Use?

To learn more, go to

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The Radiologist’s Guide to Meaningful Use: What’s it all about, why was it created, who is it for, and what’s inside?

Meaningful use, a term born out of the American Recovery and Reinvestment Act (ARRA) of 2009, refers to the use of certified electronic health record (EHR) technology to promote health care improvements and advance the electronic exchange of information among health care professionals. This program, designed to encourage health care professionals and hospitals to use certified EHR technology and demonstrate compliance through a series of measures and criteria, provides financial incentives for achieving health and efficiency goals over a prescribed timeframe.

Why was this guide created?

Since the introduction of meaningful use there has been miscommunication and confusion among medical specialists. In the radiology community, limited information and guidance has led to a number of meaningful use myths. That’s why the authors created this guide—to clear up the confusion, to provide a factual representation of the legislation and regulations as they apply to radiology professionals, and to offer a strategic approach to meaningful use for the medical imaging community.

Who is this guide for? 

Everyone involved in the management and delivery of diagnostic imaging services—ranging from radiologists to practice administrators, IT leads and CIOs, to healthcare IT vendors and others. This guide will help you prepare for meaningful use, develop and execute your strategy, and sustain your compliance with the CMS Electronic Health Records (EHR) Incentive Programs.

What’s inside this guide?

The Radiologist’s Guide to Meaningful Use is divided into four parts and each section builds upon the prior to ensure you have the necessary tools to successfully achieve meaningful use in radiology. Part I covers the fundamentals, Part II provides a 10-step approach to becoming a meaningful user, Part II examines how imaging practices are coping with MU through first-hand experience interviews, and Part IV offers guidance for staying informed.

In addition to the information contained in the pages of the book, an online companion website offers notification of content changes, information updates, and downloadable worksheets to be used in conjunction with the guide.

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Available now: The Radiologist’s Guide to Meaningful Use


Comprehensive Guide Cuts Through Clutter and Gives Radiologists the Confidence and Know-How to be Successful with the Stage 1 CMS EHR Incentive Programs

In their book “The Radiologist’s Guide to Meaningful Use: A step-by-step approach to the Stage 1 CMS EHR Incentive Programs” (ISBN: 978-0615563169), Jonathon L. Dreyer and Dr. Keith J. Dreyer help radiologists and imaging practices prepare, develop, execute, and sustain a successful and effective meaningful use strategy.

A Strategic Plan for Meaningful Use Success

By creating a simple road map that is easy to follow, the authors offer pragmatic and useful recommendations that readers can apply to their imaging practices. Beginning with the fundamentals, the authors present an overview of the program, dive into the legislation and regulations, touch on incentives and penalties, review Stage 1 objectives and measures, discuss the product certification process, and tie everything back to how it applies to radiology professionals.

Once the reader is educated on the basics, the guide transitions into a 10-step approach for how to become a meaningful user by discussing preparation techniques, tips for developing your strategy, details on executing your strategy, and how to sustain compliance with the program.

Next, the authors interview leaders in the community who talk about their experiences with meaningful use and offer best practice advice for success.

Finally, the book concludes by offering guidance for staying informed, reviews ongoing advocacy efforts, takes a look at available resources and tools, tackles frequently asked questions, and leaves the reader with the confidence to take on meaningful use.

Companion Website:

Meaningful use is an evolving subject and it is critical to have access to the most current information. To enhance the reader’s experience, the authors have incorporated quick reference (QR) codes throughout the text of the guide. These access points direct the reader to an online reference website where the most up-to-date information and downloadable companion material can be found.

Giving Back to Improve Health Care

The primary goal of meaningful use is to improve health care quality, safety, and efficiency while reducing health disparities. In an effort to support better health care as the nation makes this transition, a portion of both author’s proceeds, and 100 percent of Dr. Keith J. Dreyer’s proceeds, will be donated to various health care charities that are improving patient care and overall population health today.

About the Book

The trade paperback of The Radiologist’s Guide to Meaningful Use is 6 by 9 inches, 240 pages, with a cover price of $59.95, ISBN: 978-0615563169. The book is available now on ( and through the guide’s official e-store on

About the Authors

Jonathon L. Dreyer is a senior health care marketing professional in Boston, Massachusetts. His deep understanding of medical imaging technology and healthcare IT has contributed to the development and successful deployment of technology across a number of health care verticals. He has authored several articles on clinical decision support, radiology reporting, speech recognition, business intelligence, electronic health records, meaningful use, and mHealth and is an active blogger and contributor to standards and interoperability projects.

Keith J. Dreyer, DO, PhD, FSIIM is the Vice Chairman of Radiology Informatics at Massachusetts General Hospital and Assistant Professor of Radiology at the Harvard Medical School. He is a Diagnostic Radiologist, certified by the American Board of Radiology with a PhD in Computer Science. Dr. Dreyer holds, and has held, numerous board and committee positions with the ACR, RSNA, SIIM, and other national medical societies and has authored numerous scientific papers, articles and books, as well as lectures worldwide on digital imaging, medical informatics, clinical language understanding, and electronic health records.

Additional Information for the Media

To download an electronic version of the press release, additional book information, testimonials, cover artwork, author headshots, and bios, please go to