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Finding Greater Meaning in Stage 2 Meaningful Use
By David Rosenfeld
Proposed rules for stage 2 of the federal government’s electronic health record (EHR) incentive program were issued in late February, and the reaction from the radiology community has been somewhat favorable (unlike its response to the rules for stage 1). Proposed rules from CMS and the Office of the National Coordinator for HIT include specific requests from the ACR® that will add relevance and needed flexibility to the program for radiologists, according to Mike Peters, director of legislative and regulatory affairs in the ACR’s government-relations department.
 “We have a pretty big platform of asks that we’ve been pushing for in terms of recommended changes to CMS and ONC regulations. I would say that almost all of our asks were addressed, to some degree—not all the way, but they were included, to a certain degree.”
—Mike Peters, ACR
CMS issued proposed rules for health-care professionals and hospitals attesting to meaningful EHR use for incentive payments in stage 2 of the program, while the HHS Office of the National Coordinator (ONC) put out proposed rules for certifying EHR technology. Comments on each set of rules will be accepted through the first week of May, with the final rules expected this summer.
Practices that begin attesting this year for stage 1 will not forfeit any of the combined $44,000 (over five years) available, per eligible professional, for complying. Physicians will, however, lose a portion of incentive pay if they wait until 2013, with penalties for noncompliance set to begin in 2015. The federal government had already made $2.5 billion in incentive payments by the end of 2011, according to CMS.
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Embarking on the Meaningful-use Path
By Jim Morgan and Reynold Yordy
  How elusive is the goal of meaningful use among imaging groups? We know of only a handful of US radiology practices that have qualified. Relying on in-house talent is a great way to get it done, but not many practices have the personnel needed to research the complexities involved. Selecting and deploying the correct technology, and then attesting to receive incentive payments, are no small tasks.
A meaningful-use consultant can be an excellent idea, and there are regional extension centers throughout the United States designated to help with this, in addition to a list of consultants available at www.radiologymu.org. Even with a consultant’s help, many staff members might look at the new responsibilities and quickly conclude that meaningful use is just one more task that they must do for the benefit of the radiologist’s wallet.
To avoid this dissatisfaction, emphasize that the overall CMS plan is to improve the quality of patient care and reduce redundant and unnecessary procedures. In addition, staff members should know that there are potential cuts in reimbursement for noncompliance (a penalty that helps no one).
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Call to Interoperability Action: What Would Amazon Do?
By Cheryl Proval
In reviewing a schematic diagram of the integration points of the imaging information systems of Kaiser Northern California (Oakland), Richard (Skip) Kennedy, MS, bewails the current state of point-to-point integration in health care. Not only is this approach inefficient, time intensive, and wildly expensive, it’s not working very well.
On March 22, 2012, Kennedy presented “The Blind Men and the Elephant: A Parable of Imaging IT Interoperability” at a Long Beach, California, regional meeting of the Society for Imaging Informatics in Medicine. In the presentation, Kennedy (who is technical director of imaging informatics, Northern California, Kaiser Permanente) explains not only why health-care IT should evolve, but why it must.
 “We worked in an interfacing environment that’s dedicated to building very professional, very custom-crafted Rolls Royce Phantoms, and we’re living in a world now, in health care, that can only afford an Accord. We’re not going to be able to spend $300,000 for interfacing anymore.”
—Richard (Skip) Kennedy, MS
In preparation for his presentation, Kennedy tried to figure out how many man-hours went into the nearly 50 interfaces linking his information systems (see figure).He gave up; he did, however, report that each HL7 interface took an average of six to nine months to complete.
“We spend an enormous amount of time building these interfaces, and the sad thing is, frankly, about 90% of the content between these interfaces is all replicated: This is the same information we are sending from system to system, and that’s how we always have done it,” he says. “I am going to make an argument that this is a bad way of doing it, and that we have better ways to do it.”
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Stage 2 Heightens Security Concerns
Three components in the proposed rule for stage 2 MU could translate into greater vulnerability to security breaches, according to Adam Greene, JD, formerly with the HHS Office of Civil Rights: providing patient access to their data via a portal; greater participation in HIEs; and providing secure messaging for patients.
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Meaningful Use Is Not Enough
The CEO of Dean Health System (Madison, Wisconsin) believes that in order to thrive, health-care providers must go beyond meaningful use to achieve optimal use. He attributes the successful transformation of the system to a willingness to embrace health IT and the effective use of data to drive decisions.
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Automated Tracing Tool to Assess Noncalcified Plaque
A team at Stanford University School of Medicine has developed an algorithm to automate the assessment of visceral and peripheral ischemic and aneurysmal vascular disease through the quantification of noncalcified plaque in CT angiograms. The account appears in the Journal of Digital Imaging.
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MU Incentive Pay for EPs Soars in March
The latest data from CMS indicate that physician electronic health recordincentive payments leaped 57% beyond February payments, for a cumulative total of$636 million, according to an article in Modern Physician. Hospitals’ payments increased just 10% over February payments, for a cumulative total of $1.4 billion.
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Mobile Health 2012
Sponsored by Stanford University
May 16–17
Stanford, California
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SIIM 2012 Annual Meeting
Sponsored by the Society for Imaging Informatics in Medicine
June 7–10, 2012
Orlando, Florida
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Planning for Pathology Informatics 2012
Sponsored by the University of Pittsburgh and the Association for Pathology Informatics
October 9–12
Chicago, Illinois
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