The government may be pouring billions into promoting EHR adoption, but when it comes to radiologists, the payoff may be long in coming and difficult to attain.

That was one message that came across loud and clear during a panel discussion at RSNA 2010 in Chicago. "The program is not a gift to radiologists, but at best is a partly funded mandate," said Ramin Khorasani, M.D., Brigham and Women's Hospital, Boston. "Even if the products they use are certified, most radiologists will have gaps in qualifying for stage 1."

Part of the problem, the panelists asserted, is that radiologists practice medicine in a very different way than do internists and family practice providers, whom they say the MU program is tilted to. Ironically, radiologists have been among the industry's earliest adopters of IT, having long embraced picture archiving systems and automated scheduling and information systems that work in tandem with them. But the RIS and PACs technologies that radiologists have embraced would only fulfill a handful of criteria under the meaningful use program for ambulatory practices, noted Keith Dreyer, D.O., vice chair, radiology, at Massachusetts General Hospital, Boston.

Panelist David Mendelson, M.D., director of radiology informatics at Mt. Sinai Hospital, observed that radiologists and other specialists would have a tough time qualifying under the MU program. "Meaningful use is outside of the way we take care of patients," he said. "I'm not sure if Congress did us a favor or not."

Mendelson said that radiology practices seeking to apply for the incentives should name a point person to pore through the regulations and decipher their impact on the group. Some MU measures may be excluded, but physicians would need to justify that in any attestation to CMS. Panelists said that no single EHR product on the market today could fulfill all of the MU criteria for a radiology practice, and that practices would have to adopt modular products that were certified in order to qualify. Mendelson went so far as to say there would be no downside for radiology practices to postpone any headlong rush into an EHR, because CMS might further revise criteria to facilitate specialist participation.

Dreyer demonstrated an online tool,, which provides links to MU participation criteria and lists of certified products. The site also includes an analysis tool to help practices determine their eligibility and the amount of money at stake. Small radiology groups should conduct a cost-benefit analysis to weigh the benefits of participating against the costs of new technology and staffing needed to acquire them, Mendelson said.  

--Gary Baldwin


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