NOV 29, 2011 11:41am ET

Image is Everything--Almost--at RSNA 2011

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The massive medical imaging exhibition--an annual late-November, bone-chilling tradition here in Chicago--is off to a great start.

There's the usual assortment of over-the-top vendor exhibits ("The GE booth has its own zip code" one attendee told me), deeply clinical presentations ("Improved Assessment of Bile Duct Variations with Flip Angle Modulations in Gd-EOB-DTPA-enhanced MRI as Compared to MRCP"), and of course, meaningful use--with a twist.

Radiology, you see, pretty much got slighted in the first round of the government EHR incentive program, which was stacked toward primary care. The irony, of course, is that radiology has long been ahead of the technology curve in the industry.  But many radiologists are keen in participating in the program. They already are feeling the reimbursement pinch, and don't relish the idea of additional punitive cuts from Medicare for non-participation.

On Monday, I attended a session moderated by Keith Dreyer, DO, the vice chair of radiology at Massachusetts General Hospital and long-time informatics proponent, which examined meaningful use from the radiology perspective. Dreyer discussed some meaningful use survey results, including a survey from the RSNA informatics committee about what future iterations of meaningful use should look like. That survey suggests that radiologists are not as inwardly focused--or at least as image-focused--as you might imagine. Future versions of the meaningful use requirements, according to the radiologists surveyed, should include more robust exchange of ordering information and results reporting between referring physicians and radiologists. Beyond that, the radiologists would like to see more requirements around patient-mediated exchange of images and data. And most surprising of all, the radiologists called for establishment of unique patient identifiers (once part of the original HIPAA legislation, Dreyer reminded the audience) to help uphold safety.

The meaningful use program may have slighted radiologists at the get-go, but some practices are embracing the idea wholeheartedly. Among these are University Radiology Group in New Jersey, whose CIO Alberto Goldszal described how his group adapted its RIS to accommodate many criteria. The meaningful use program has resulted in new data captures and workflows at the group practice (which I featured in a November article). Goldszal noted that some aspects of the program, such as the patient portal, turned into a positive customer win. "The portal has been a big plus for us," he said. "Patients said the only thing they had ever seen from a radiologist before was the bill."

There you have it in a nutshell: A practice must comply with a federal program, builds a patient portal and patients like it. Radiologists, you see, are physicians at heart, and they have the patient in mind as much as the internists and primary care doctors that the feds so desperately want on EHRs.

 

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Physicians, frequently perceived as a roadblock to a high-quality/low-cost paradigm, often spearhead IT advances central to the effort.

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