In a Thursday morning open-mike/town hall session on the federal meaningful use program, Curtis Langlotz, MD, PhD, offered a reality check for those incentive-happy practices that have successfully attested to Stage 1.
“Currently we’ve had a lot of carrots,” he notes. “I suspect there will be some sticks.” If CMS is not paying for hospital readmissions within 30 days of discharge, he speculates, could the same happen for duplicate images if another was taken within a specified time period?
The implications of such a policy for provider business models, the sharing of data, and the use of information technology would be quite profound.
Langlotz was joined on the panel by the ACR ‘s Mike Peters, senior director of legislative & regulatory relations, and an old friend from his residency days at Stanford, Doug Fridsma, MD, PhD, an internist who is now serving as chief science officer for the ONC. Fridsma advised radiologists to take a long view of the program.
“There’s a long tail to what is going on here,” he says. With payment reform and the accountable-care movement, think about how can MU get you to the place where you need to go to participate, he advises.
Over the three stages of MU (and even he couldn’t offer specifics on stage 3), Fridsma sees a movement from document exchange to data exchange, from point-to-point exchange to a more collaborative exchange, and a health IT world with more simple plug-and-play. “ACOs will create a more Google-like exchange of information,” he believes.
A Google-like Approach
A booth in the South Hall of McCormick Center offered a window on this future. Ron Hosenfeld, CEO, Lucent, which markets a portfolio of workflow and analytic tools for radiologists is also CIO of Riverside Radiology, which has created a virtual patient archive after a study of the practice’s hospital clients revealed that 30 percent of patients move among hospitals.
“If I go in to have a chest x-ray and they find a nodule, without having access to the chest X-ray I had for a softball injury at another site, they are not going to know if its stable or not,” Hosenfeld says.
Riverside’s approach is much more Google-like than an HIE. “We write software called collectors that simplify the image management experience,” he explains. “We talk to our hospitals, we create a connection, and our web bots search their entire archive. That data is correlated with other collectors connecting to different hospitals, and, going back to that first example, now I don’t have to wait to find out if I have cancer, I find out on the spot.”
Circling back to Langlotz’s comment about what value-based payment could look like for radiologists, practices and departments would be well advised to anticipate what lies ahead as they build their HIT road map and to invest their incentive dollars wisely.
With today’s news that the government will give providers an extra year to meet Stage 2 requirements (thereby delaying the start of Stage 3 to 2017 at the earliest), radiologists will have an extra year to consider, devise, and implement their strategies.