Radiologists in the United States are currently facing a dilemma as far as \u201cmeaningful use\u201d (MU) of Electronic Health Records (EHRs) is concerned. The American College of Radiology (ACR) IT and Informatics Committee leaders and staff have met the National Coordinator for HIT (ONC) as well as Center for Medicare and Medicaid Services (CMS) staff to discuss the HR incentive program from the point of view of radiologists, on October 13, 2011.<\/p>\n
The American College of Radiology committee reiterated its previous requests for certain criteria regarding meaningful use such as \u2013 the sharing or accessing imaging data as part of Meaningful Use, robust radiology order entry requirements for referring physicians with appropriate clinical decision support, and addressing Meaningful Use challenges within the radiology community and other specialties.<\/p>\n
The American College of Radiology Meaningful Use Report<\/strong><\/p>\n A report released by the ACR regarding Meaningful Use for radiologists specifies the steps taken by the CMS regarding some of the \u201cCore\u201d and \u201cMenu\u201d objectives and their relevance to radiology. The reports summary states that according to the Continuing Extension Act, outpatient hospital settings (POS Code22) are not considered hospitals in the EHR incentive program. A vast majority of radiologists will be eligible for the Medicare version of the EHR incentive program.<\/p>\n Defining Hospital-based Physicians<\/strong><\/p>\n The report by ACR also states who would be considered as hospital-based by the CMS and would be ineligible for the incentive program. The CMS defines hospital-based physicians as those providing 90 percent or more of their covered professional services in inpatient (POS Code 21) and emergency room (POS Code 23) settings. Therefore hospital-based radiologists who do not meet the above mentioned criteria are eligible for the Medicare incentive program. However, Medicaid eligibility has stricter rules that require the EP\u2019s 30 percent volume must be attributable to Medicaid which is a tall order for any radiologist if not impossible.<\/p>\n Who is Qualified?<\/strong><\/p>\n The Medicare version of the incentive program only applies to physicians and radiologic technologists, medical physicists, or other technical staff is not eligible. However, the Medicaid version of the incentive program is limited to physicians, Certified Nurse Midwives, Nurse Practitioners, and Physician Assistants who furnish services in a Federally Qualified Health Center or Rural Health Clinic that is led by a Physician Assistant.<\/p>\n Radiologists vs. Primary Care<\/strong><\/p>\n The meaningful use objectives appear to be focused on primary care and present some confusion as to how radiologists would comply with such objectives. However, CMS provides exclusions to many meaningful use measures as well as \u201cmenu set\u201d measures to counteract this problem to adjust specialties such as radiology.<\/p>\n