Radiologists put MU on back burner

Objectives for imaging come into focus in Stage 2
By Tom Sullivan
05:11 PM

It’s been written that “imaging was given the cold shoulder in the first phase of the meaningful use program.” Moving into Stage 2, that is no longer true. It looks to be easier for radiologists than its predecessor – which is not to say they’ll flock to the incentive program en masse.

Still, Stage 2 is likely to be among the most discussed topics at RSNA 2012, which kicks off Nov. 25 in Chicago, and a welcome one at that for the massive show’s particular audience. 

“When it comes to meaningful use, many radiologists are still not up to speed with the whole concept,” George Bisset, MD, president of the Radiological Society of North America (RSNA) said. “I think there are a lot of people in private practice who will look at you with blank stares if you talk about meaningful use.”

At last year’s shindig the message to radiologists was that Stage 1 meaningful use is achievable, but more needed to be done in Stage 2 particular to imaging.

“In Stage 2, there are two MU objectives that require the reporting of image ordering and image viewing through the EHR,” explained Julie Nakhle, a healthcare consultant at Lineage Consulting.

Other imaging-centric updates to meaningful use, according to an article RSNA published in September 2012, titled "Radiologists cautiously optimistic about Stage 2," include: “compliance exemptions for many hospital-based providers who are not involved in their facility's information technology decisions, a discretionary menu set objective targeted toward diagnostic image accessibility in EHRs, recommendations for radiology-relevant clinical quality measures, more flexible definitions of what constitutes justified EHR, and a consolidation of the eligible hospital and eligible professional technology certification criteria.”

Nakhle added that “because of the expanded use of ‘seen by EP’ language and Office Visit exemptions, I think Stage 2 will be far easier for the typical radiologist to achieve.”

But easier, in this instance, does not necessarily mean "easy."

Nicholas Bartz, senior analyst at The Advisory Board Company pointed out that to qualify for reimbursement, radiologists still must collect “a staggering amount of new patient data, much of which is outside their clinical practice,” so the matter of extracting that information will be very disruptive.

“Many radiology practices will likely choose to forgo participation in the program and its financial incentives, especially now that they can exempt themselves from financial penalties in 2015,” Bartz continued. “Unfortunately, individual penalty exemptions can only be issued for a maximum of five years, leaving radiologists in a precarious position moving forward. ”

RSNA’s Bisset essentially agreed, saying he anticipates many radiologists will delay meaningful use, at least until doing so has a negative impact. 

“I think a lot of people are ignoring it because it may not be large dollars and there is no penalty,” Bisset continued. “When we get to the point where there is a penalty, I think you’ll see people learning quickly about it.”

Lineage Consulting’s Nakhle pointed to another scenario likely to kick start radiologists toward meaningful use.

“With more than 300,000 eligible professionals registered for the programs already, ordering physicians will begin to demand access to imaging facilities that can participate with the program so they can maintain compliance with imaging measures, and thus the MU program itself,” Nakhle explained.

And while Bartz and Bisset agreed that radiologists are likely to push meaningful use back as far as they can, Nakhle cautioned that it will be difficult to catch up later.

“All physicians must complete two years of Stage 1 before they can begin Stage 2," Nakhle explained. "Think of it as a curriculum where each stage takes two years to complete and you cannot advance to the next stage without successfully completing the previous stage. But the incentive opportunities end in 2016. Therefore, for radiologists to take advantage of the incentives and move into later stages, they need to begin as soon as possible.”

Senior Editor Mary Mosquera (@GovHITreporter) contributed to this report.