An estimated 95% of radiologists are believed to be eligible for meaningful use dollars, but just 230 are in receipt of their first payments, and 85 of them belong to University Radiology Group in New Jersey, where Alberto Goldszal, MBA, is CIO. Time flies, so the rest of the specialty best make haste to get into compliance, because penalties will be assessed beginning in 2015.
Stage 1 is all about collecting data, much of which has not been collected before.
Goldszal, MU guru Keith Dreyer, DO, vice chair of informatics at MGH (attesting in 2012 for Stage 1), and Sheryl Streich of CDI, shared wisdom they earned on the front lines of attestation in a session on Thursday at SIIM. Highlights include:
- If you are a radiologist issuing more than 100 prescriptions per year, you will be penalized if you do not do e-prescribing. While most radiologists (IRs and some breast imagers who do biopsies excepted) do not prescribe more than 100 prescriptions per year (contrast is considered a consumable), you can't know who does or doesn't unless you track and measure everyone: Goldszal
- For practices intending to participate in e-prescribing, SureScripts certification process is almost as tough as getting an EHR certified: Be sure you have two people in the room because it is an 8 hour process: Streich
- At URG, the new MU workflow has been engineered in such a way that radiologists are responsible for just 4% of the effort. Most of the work is done by front desk personnel, which collects 42%, and the RIS, which collects 35% of the data (via 5 different DICOM and HL7 interfaces): Goldszal
- Don't wait until October to begin the 90-day attestation required for Stage 1: Give yourself a two-month time cushion as there may be some cleanup necessary on the data collection side: Dreyer
- Once your technical and operational solution is in place, give your practice or department 30 days to routinize the new workflow (training period on the RIS, etc), before you begin actual attestation: Streich and Goldszal
- Appoint a data collection police and make everyone accountable for their part of the effort: Streich
- To meet the Protect PHI core measure, do external risk assessment twice a year on all Internet-facing servers, which may trigger a solution as simple as downloading a patch from Microsoft: Goldszal
- A shortcut to meeting the requirement for three clinical quality measures is to ask the following yes-or-no questions: did you have a mammogram in the past year (women over 40), did you have a colorectal cancer screening in the past five years (60 and over), and did you have a vaccination in the past year? Goldszal
- For hospital-based radiology practices that are having a tough time getting the attention and support of the CIO for attestation, perhaps offering to help the hospital meet the two core and one menu set patient engagement measures will help. At MGH, enrolling all radiology patients in their Gateway portal for access to images and reports helped push the hospital over the 50% threshold requirement to provide patients with timely electronic access to their health data: Dreyer
- Ditto on helping the hospital meet the Maintain Problem List core measure, which requires hospitals to maintain a list of current and active diagnoses for more than 80% of admitted patients. Because radiology exams are mapped to ICD-9 codes, the department can make a significant contribution to that 80% requirement: Dreyer