Inverness Medical Imaging (Inverness, Florida) had an especially strong motivation to apply for federal meaningful-use incentives: With a payor mix that was 60% Medicare, the radiology practice knew that the eventual penalties for not attesting to meaningful use would be too big a hit to sustain. John Erler, administrator, says, “The incentives are good, but if you aren’t meaningful-use compliant, the government will eventually reduce your reimbursement through Medicare. That’s a huge portion of our business, so it made sense for us to get onboard now and get as much of the incentive money as possible.” Last year, with the meaningful-use program in mind, Erler began shopping for a new RIS/PACS for the practice; its legacy, server-based platform had already begun to be too costly for the two-radiologist group, and adding the vendor’s module for meaningful-use attestation would have increased the financial burden. “All the servers were on-site, so we had to maintain them and upgrade them—and to get meaningful use, we would have had to buy another server and pay some pretty hefty fees, on top of that,” he says. “We already had eight servers on-site. We realized we needed the whole package—a new RIS/PACS with meaningful-use capability.” Moving to the Cloud For multiple reasons, Erler decided that a hosted, cloud-based solution would be best for the practice’s next RIS/PACS platform. “With our former system, if a disaster had struck, we would have needed to replace all of our servers and the tape-backup machines (which would have been especially difficult to replace, because of their age),” he notes. “With a hosted solution, on the other hand, we could be at another site, the next day, with all of our image data up and running immediately.” In September 2012, Inverness Medical Imaging implemented the PowerServer RIS/PACS/meaningful-use platform from RamSoft. Entirely cloud based, PowerServer includes a built-in workflow engine and a certified complete electronic health record, making attestation for the meaningful-use program possible without an up-front capital investment. “RamSoft’s solution is a lot better and more comprehensive than the platform we had before,” Erler says. “There was also a lot less up-front cost because we didn’t have to buy servers or software. I am the IT staff for our organization, so the decision to go with RamSoft made my life a lot easier.” Erler adds that the transition to the hosted solution helps futureproof the practice as well, eliminating the possibility of unexpected expenses in the years to come. “We no longer have to worry about replacing aging servers or dealing with problems from hard drives going bad,” he says. “We won’t have situations where the system goes down and we can’t continue working until we get it fixed.” The cloud-based solution also benefits the group’s patients. Erler notes, “RamSoft is better for them because it enables us to get reports out more quickly.” Hosted Attestation By taking advantage of the PowerServer RIS/PACS/meaningful-use platform, Inverness Medical Imaging was able to attest successfully for stage 1 of meaningful use, garnering $18,000 in incentive payments for each of its radiologists. “We paid up front for the implementation of the RIS/PACS, and now, we’re paying for it monthly,” Erler says. “The incentive payments that we received paid for the implementation right off the bat.” The attestation process required some additional work on Erler’s part, as well as on the part of his front-desk staff. “The biggest challenge, for me, was doing the required security-risk analysis,” he recalls. “I handled the implementation of the new system. The front-desk staff asks patients the additional questions and inputs the data. It takes time, but only adds minimal extra paperwork to our load. In terms of the radiologists’ workflow, it doesn’t affect them at all.” At the end of the meaningful-use reporting period, the PowerServer RIS/PACS/meaningful-use platform automatically compiles each radiologist’s report from the previously input data, drastically reducing the administrative burden placed on the group. “We can print a report showing all the necessary data, and all we have to do is send it in,” Erler says. “What RamSoft is doing to help us get through the meaningful-use program is great. Its software makes it very simple for us; the job is much easier than if we had to go through and do this by hand.” Looking Ahead So far, Erler’s experience with the meaningful-use program has been mixed. Most of Inverness Medical Imaging’s patients decline to share their information, and communication with other organizations’ information systems remains difficult. “Right now, too many of the systems that are out there are incompatible,” Erler says. “We need to get everyone on a single standard so that all these platforms can talk to each other. Until that happens, it’s unclear whether doing this will help us.” He is certain of two things, however: Meaningful use is here to stay, and delaying participation is a mistake. “The people waiting to do this are just missing out on money. Eventually, they’ll be in a position similar to ours, where the majority of their population is on government health plans; then, they won’t be able to afford not to do it. It makes perfect sense to do it now, before the penalties make it impossible not to,” he says. Cat Vasko is editor of ImagingBiz.com and associate editor of Radiology Business Journal.
The Cloud-based Approach to Meaningful Use: Inverness Medical Imaging