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

Presenters:

  • 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.

Find more educational sessions on RSNA.org »

Ready to learn more, buy a book today! 

Go to http://www.theMUguide.com to learn more. Buy a book from the official e-store (http://buy.theMUguide.com) or Amazon.com (http://amazon.theMUguide.com).

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.

Ready to learn more, buy a book today! 

Go to http://www.theMUguide.com to learn more. Buy a book from the official e-store (http://buy.theMUguide.com) or Amazon.com (http://amazon.theMUguide.com).

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.”

Ready to learn more, buy a book today!

Go to http://www.theMUguide.com to learn more. Buy a book from the official e-store (http://buy.theMUguide.com) or Amazon.com (http://amazon.theMUguide.com).

 

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.

Background

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.

Ready to learn more, buy a book today!

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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.

Ready to learn more, buy a book today!

Go to http://www.theMUguide.com to learn more. Buy a book from the official e-store (http://buy.theMUguide.com) or Amazon.com (http://amazon.theMUguide.com).

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.

Ready to learn more, buy a book today!

Go to http://www.theMUguide.com to learn more. Buy a book from the official e-store (http://buy.theMUguide.com) or Amazon.com (http://amazon.theMUguide.com).

 

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.

Ready to learn more, buy a book today!

Go to http://www.theMUguide.com to learn more. Buy a book from the official e-store (http://buy.theMUguide.com) or Amazon.com (http://amazon.theMUguide.com).

2014 CEHRT Hardship Exception Guidance for EPs

In this month’s post, we take a look at the 2014 CEHRT Hardship Exception Guidance for Eligible Professionals (EPs). 

If you are an eligible professional, and you are unable to implement the 2014 Edition of Certified Electronic Health Record (EHR) Technology in time to successfully demonstrate meaningful use for the 2014 reporting year, you may be eligible for a hardship exception from the applicable Medicare payment adjustment.

When do payment adjustments take effect for the 2014 reporting year?

The Medicare EHR Incentive Program payment adjustment is applied in 2016 for the 2014 reporting year for providers who demonstrated meaningful use in a previous year. New participants in the 2014 reporting year can also apply for an exception to the 2015 payment adjustment. CMS is currently accepting hardship exception applications for the 2015 payment adjustment only.

New Participants in 2014

If you are new to the program and intended to demonstrate meaningful use for the first time in 2014, but you are not able to implement 2014 certified EHR technology for the 2014 reporting year, you may apply for a hardship exception for the 2015 payment adjustment.

  • Use the eligible professional hardship exception form for 2015
  • Indicate the reason you are applying for a hardship (select “2014 Vendor Issues”)
  • Submit your application by July 1, 2014

Returning Meaningful Users in 2014

If you successfully demonstrated meaningful use for the 2013 reporting year, you will not be subject to the 2015 payment adjustment. If you are not able to implement 2014 certified EHR technology for a 2014 reporting period, you may apply for a hardship exception for the 2016 payment adjustment.

  • Use the eligible professional hardship exception form for 2016 which will be available after July 1, 2014
  • Indicate the reason you are applying for a hardship (select “2014 Vendor Issues”)
  • Submit your application by July 1, 2015

For more information, please review the 2014 CEHRT Hardship Exception Guidance for Eligible Professionals documentation posted on the CMS website: http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CEHRT2014_HEGuidance_EPs.pdf

Ready to learn more, buy a book today!

Go to http://www.theMUguide.com to learn more. Buy a book from the official e-store (http://buy.theMUguide.com) or Amazon.com (http://amazon.theMUguide.com).

It’s 2014, time for Stage 2 MU (and some updates for Stage 1)

In this month’s post, we take a look at 2014, Stage 2 MU, and changes for Stage 1 MU. 

For the radiologists that have already completed two years of Stage 1 MU, 2014 will be the year Stage 2 MU begins. Stage 2 retains the same basic structure as MU Stage 1 and providers must report on 20 objectives (17 core objectives and 3 out of a possible 6 menu objectives) in Stage 2. The meaningful use measures are split into core and menu objectives—eligible professionals must report on all core objectives, but can choose the menu measures that pertain to their practice.

CMS and the ONC have established standards and certification criteria for structured data that EHRs must use in order to successfully capture and calculate objectives for Stage 2 of meaningful use. These new standards and certification criteria will take effect in 2014. EHR technology that is certified to the 2014 standards and certification criteria will allow providers to meet both Stage 1 and Stage 2 meaningful use requirements (for more information about certified EHRs and the new 2014 standards and certification criteria, please visit ONC’s new 2014 Certification Programs and Policy page: http://www.healthit.gov/policy-researchers-implementers/about-certification).

For 2014 Only

Because all providers must upgrade or adopt newly certified EHRs in 2014, all providers regardless of their stage of meaningful use are only required to demonstrate meaningful use for a three-month (or 90-day) EHR reporting period in 2014: Medicare eligible professionals in their first year of meaningful use may select any 90-day reporting period. Medicaid eligible professionals can select any 90-day reporting period that falls within the 2014 calendar year.

Stage 2 MU Requirements

17 Core Objectives – These are objectives that everyone who participates in Stage 2 must meet. Some of the core objectives have exclusions, but many do not.

3 of 6 Menu Objectives – You only have to report on 3 out of the 6 available menu objectives for Stage 2. You can choose objectives that make sense for your workflow or practice. Again, some of these objectives have exclusions.

Many of the objectives in Stage 2 are similar to Stage 1. Some objectives that were in the menu set in Stage 1 have been moved to the core set for Stage 2 and are now required for all providers. Some objectives that were in the core set in Stage 1 now have higher thresholds that you must achieve in order to successfully demonstrate meaningful use of your EHR in Stage 2. There are also new Stage 2 core and menu objectives.

For more information about Stage 2 MU, visit http//www.healthmu.org/radiology/beyondstage1.php.

Ready to learn more, buy a book today! 

Go to http://www.theMUguide.com to learn more. Buy a book from the official e-store (http://buy.theMUguide.com) or Amazon.com (http://amazon.theMUguide.com).

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.

Ready to learn more, buy a book today!

Go to http://www.theMUguide.com to learn more. Buy a book from the official e-store (http://buy.theMUguide.com) or Amazon.com (http://amazon.theMUguide.com).