Meaningful Use: Radiology group achieves attestation success under unique circumstances

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 - Paul Kirpoff
Paul Kiproff, MD, president of Allegheny Radiology Associates, LTD


Many radiology groups have already committed to meaningful use (MU) of health IT to reap the financial benefits of utilizing electronic health records, but a high percentage remain on the sidelines. Some of the reluctance could be attributed to the belief that the cost will outweigh the benefit, but that disregards the fact that referring physicians who have attested will need to connect with specialty providers for phase 2 in order to continue complying with the program.

Some physicians think that attesting to MU will change the way their practice operates, adding even more work to their already busy workdays. There's no denying the attestation process (and likely subsequent audits) can be intimidating, but Paul Kiproff, MD, president of Allegheny Radiology Associates, LTD, located in Pittsburgh, PA, recounts why his group wanted to take the risk, and how they achieved success, given their unique circumstances.

Allegheny Radiology Associates is an independent radiology group that works within a large health system. Despite its independent status, the group utillizes the health network's IT infrastructure for RIS/PACS and to populate patient data in the EHR. When the radiology group first inquired about MU attestation, it was told it would not be included as part of the network's attestation. They considered whether they could attest on their own. After some external inquiries, they were told by some it was not possible for the group to attest without having its own IT infrastructure.

Assessing risk

With the knowledge they would have to complete the MU attestation as an independent group, Allegheny Radiology Associates began making inquiries of other groups that had attested to MU. “We started looking into what it would take to do it ourselves,” explains Dr. Kiproff. “We saw that most of the places that had attested were scenarios where the radiology group was a part of the hospital or health system—as an employee group. In our case we knew there would be some additional hurdles. Basically, because we are independent, we looked to others."

“We started asking questions,” he continues. “We asked our billing company and other independent groups. What we were specifically interested in knowing, was not whether attestation would be possible as an independent group from our health system, but whether or not it could be done given the fact that we were utilizing the health system’s platform.”

Completing the MU attestation on their own basically meant Allegheny Radiology Associates would need to find their own Meaningful Use Certified RIS/PACS. The group’s lack of IT footprint quickly became apparent as the elephant in the room. The investment in its entirety presented a considerable risk, given there were no plans to discontinue using the health system’s IT infrastructure and the new products needed to attest would need to integrate with it. Additionally, there was no guaranteeing successful attestation.

“That’s why we had to implement our own certified Meaningful Use RIS/PACS,” adds Steven Hamel, practice manager, Allegheny Radiology Associates. “We did not have our own IT infrastructure, and we had to go looking for that product knowing full well that we still needed to use the hospital’s IT infrastructure.

“We wanted to take advantage of the benefits available through the MU program,” adds Dr. Kiproff. “The EHR incentive is the carrot, the reward is down the road a piece, but the risk is here and now; there are costs involved. You may go through all the steps and fail. There’s no guarantee. But we really wanted to take this risk.”

Selecting a partner

During inquiries of other groups’ experiences with MU, one vendor’s name came up multiple times. RamSoft was mentioned as a helpful and experienced partner for groups looking to implement a certified MU solution.

“In the end, it came down to two vendors,” recounts Hamel. “We decided on RamSoft, partly because of their size, their experience with MU and also because of their relationships with their customers. We called some of their customers for reference and they were all very pleased with RamSoft. The decision came, however, when we were in the process of changing billing vendors, and the customer whose function it was to show us how their billing system worked for them, couldn’t say enough good things about RamSoft.”

In addition to acquiring RamSoft’s technology, the group also benefitted from RamSoft’s experience in MU attestation. “The biggest challenge for us was that two HL7 interfaces had to be built—between us and the hospital, and between us and our billing company so that we could transfer all of this data into what is now our own certified EHR,” Hamel recalls. “The health network’s IT group was very supportive throughout our attestation effort. From day one, we have been working with a team from RamSoft as well as a third-party consultant who is a specialist in meaningful use attestation. Luke at RamSoft provided great experience with meaningful use. He was especially helpful when we were audited afterward—on almost every single item.”

Successful adaptation

The group recently achieved Stage 1 attestation and is working on Stage 2. They were quite surprised when they received the notice of the electronic deposit into their account.

“There’s no denying it was great to receive the incentive check for our group. We are very thankful to the health system for supporting us in our attestation effort,” adds Dr. Kiproff. “RamSoft’s team and our consultant were with us every step of the way. If you think about it, RamSoft took on considerable risk themselves, knowing the complexity of the infrastructure required. RamSoft was able to deliver on the products, regardless of the situation. And they did a great job of minimizing our risk as well, both in terms of our financial risk, and through supporting our attestation efforts with expertise.”

The October first deadline recently passed, limiting the access to the financial incentives to those who have already begun and continue to utilize EHRs.

“Parameters are going to be declining in terms of incentive, and Meaningful Use is not going away. Five years in the future, it will just be the way things are done,” states Dr. Kiproff. “We have to accept this as standard and we, as an industry, just have to adapt.”

Claudette Lew is associate editor of