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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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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Practice Obtains MU Incentives with Some Help from its Longtime Technology Partner

In this month’s post, we take a look at a MU success story from Hartsdale Imaging in Hartsdale, NY.

Hartsdale Imaging (HI) in Hartsdale, NY has five fellowship-trained, board-certified radiologists combining both interventional and a full array of conventional multi-modality procedures.

Maintaining its tradition of innovation, forward-thinking HI became part of the first wave of imaging centers to tackle the challenges of MU for radiology in order to obtain Medicare incentives. However, a specific MU challenge was that the practice handled both patient encounters and standard radiology visits.

Fortunately, HI did not have to look any further than its own “backyard” where ADS technology had been helping the practice hum with efficiency for more than twenty years. ADS systems used include MedicsRIS and MedicsPremier for radiology PM.

Joseph Casoria, HI’s Practice Administrator noted that ADS worked closely with HI’s staff in mapping out a strategy that would most efficiently enable MU compliance with a minimum of interruption to existing workflows.

ADS reviewed how the MedicsDocAssistant EHR for Radiology would be able to support HI’s MU strategy and discussed how other ADS radiology clients successfully attested for MU. HI’s radiologists have since attested twice for Stage 1, receiving both sets of incentives and they are now looking forward to attesting to Stage 2.

“The built-in Medics MU Dashboard was an invaluable tool in reporting on the radiologists’ individual MU progress,” Casoria noted.

Besides their own incentives, HI uses MedicsConnect from ADS, a built-in capability in MedicsRIS enabling HI to securely transmit their radiology reports (via SFTP) directly to their referring physicians’ EHRs. This helps HI’s referring physicians satisfy one of their major Stage 2 requirements in the process.

Mr. Casoria said, “MedicsConnect has brought the delivery of HI’s radiology reports to a new level. Our referring physicians love how our reports are received cleanly, and in EHR-enabled format. Without question, MedicsConnect helps keep our referrers referring.”

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Proposed Last Minute MU Flexibility is a Gamble

In this month’s post, we take a look at a recent post on the Radiology and Health IT Blog.

A great update posted on Radiology and HIT Blog discusses the Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for HIT (ONC) May 23, 2014 proposed rule to allow continued use of 2011 Edition certified EHR technology to comply with the Medicare EHR Incentive Program in calendar year (CY) 2014.


The ONC’s 2014 Edition EHR certification criteria regulations for HIT products were published in September 2012. A few months later, vendors were able to submit ready products to the testing labs and certification bodies for 2014 Edition certification. Eligible professionals could opt to use 2014 Edition certified products to comply with Meaningful Use (MU) beginning in CY 2013, and the new certification status became mandatory in CY 2014. Most HIT products were not ready to be 2014 Edition certified in time for prior MU participants to take advantage of that flexibility in CY 2013 due to their yearlong reporting period. However, new MU participants only had a 90-day reporting period in CY 2013, and thus were encouraged to implement 2014 Edition certified products instead of implementing 2011 Edition products (to avoid having to upgrade again so soon).

As CY 2013 wore on, it became clear that many vendors who had commercially successful 2011 Edition certified products were not getting new versions of those products updated and submitted for testing/certification in a timely fashion. By the time most vendors were ready, there was an alleged backlog of products in the testing and certification pipeline, which apparently caused more delays.

Read more about the background, concern, and conclusion on Radiology and HIT Blog.

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ONC Updates the 2014 Edition Test Method

In this month’s post, we take a look at a recent post on the Radiology and Health IT Blog.

The Office of the National Coordinator for HIT (ONC) released an update to the 2014 Edition Test Method that supports the testing and certification of health IT products used in the Medicare/Medicaid EHR Incentive Program. Specifically, the test procedure for the key “automated numerator recording/automated measure calculation” certification criterion was modified. Also updated were the test data associated with that procedure, and the test data associated with the procedure for the “data portability” criterion.

While primarily meant for testing labs and certification bodies, the 2014 Test Method is also an important resource for industry because it essentially shows how functionality will be tested against ONC’s various certification criteria. This allows for more efficacious planning prior to product submission.

To view the original posting, please visit the Radiology and Health IT Blog.

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Meaningful Use Penalty Avoidance Deadline July 1, 2014

In this month’s post, we take a look at details related to meaningful use penalty avoidance.

A helpful reminder posted on Radiology and HIT Blog discusses the approaching penalty avoidance deadline.

The application deadline for obtaining one of the significant hardship exception options from calendar year (CY) 2015 EHR Incentive Program penalties is July 1, 2014. Beyond the application-based hardship exception options, there are automatically-granted significant hardship exception options for newly practicing physicians and physicians whose primary specialty codes in PECOS are “diagnostic radiology” (30), “nuclear medicine” (36), “interventional radiology” (94), anesthesiology (05), or pathology (22) as determined approximately six months prior to the penalty year (so, also July 1, 2014).

Importantly, most American College of Radiology members will not need to take any further action to avoid the CY 2015 penalties other than to double-check their own PECOS data to make sure their primary specialty code is 30, 36, or 94. Radiation oncologists and other radiologists with different primary specialty codes will need to either demonstrate Meaningful Use (MU) by the appropriate deadline in 2014 or manually apply for one of the other significant hardship exceptions before July 1.

Links to resources:

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

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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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