Improving MU for radiology

Meaningful use (MU) criteria often covers elements irrelevant to radiology, however, an editorial published in the November issue of Radiology offers up new categories of criteria for health IT use to make the incentive program more effective at improving imaging.

Many radiologists are struggling to apply MU criteria to their practices, according to authors Tara A. Morgan, MD, of the University of California-San Francisco, and colleagues.

“As implementation of the meaningful use program continues and each new stage of regulation is updated and released, we believe that it is critical for radiologists and other specialists to play an active role in the development of meaningful use criteria that are applicable to their specialties,” they wrote.

The seven categories created by the authors are designed to positively benefit the quality of health care, increase efficiency and productivity, and apply specifically to the practice of radiology.

The criteria identified by Morgan and colleagues include electronic image storage and display, information exchange between referring providers and radiologists, information exchange between health care institutions, patient engagement, clinical decision support for radiologists, clinical decision support for referring providers, and clinical quality measurement.

Below are the authors’ major supporting points for each category.

Electronic image storage and display

• PACS for image storage and display are crucial for radiologists’ efficiency and workflow.

Information exchange among radiologists and referring providers

• This exchange is critical for successful communication and workflow.
• Radiologists can send imaging reports to the EMR, leading to timely turnaround, rapid availability of imaging interpretation, and faster clinical decision making
• Electronic imaging requests can be received.
• Maintains the database for communication between referring providers and radiologists regarding unexpected findings necessitating a follow-up.
• Physicians can receive electronic reminders about patients recommended for follow-up imaging
• Clinical data can be imported and viewed to help develop protocols and imaging techniques.

Clinical decision support for referring providers

• Helps referring providers request the most appropriate radiologic exam.
• Clinical decision support software tools have pertinent clinical information that aids radiologists in creating protocols and interpreting exams.
• Information such as patient history, progress notes, vital signs, laboratory results, and medication lists assists in accurately interpreting images and ensuring that the clinical question is being addressed.
• Integrated access offers reliable and time-efficient information.
• Access to complete, multi-institutional imaging history reduces a patient’s cumulative radiation.

Patient engagement

• Involves patients in their own imaging health care through electronic means.
• Allows patients to schedule or cancel appointments, as well as view electronic images and reports.
• Could include electronic patient reminders to schedule nonroutine, nonemergency imaging.
• Patient-mediated sharing of medical records between institutions would be efficient, saving time for those who are accustomed to electronic communication.

Clinical quality measurement

• Gives feedback and enables intervention and improvement for the timeliness of reporting, patient wait time, and communication between radiologists and referring providers.
• Could potentially track and measure percentages of unexpected clinical findings or imaging orders that contained relevant history and examination indication.
• Could improve workflow by measuring the wait time for outpatient scheduling and median patient wait time in the radiology department.
• Could enable positive intervention for a radiology practice.

“We hope that there will be some redirection of the meaningful use criteria in the upcoming revisions to the program so that the goal of a useful, portable, and secure electronic health records can be realized,” wrote Morgan and colleagues. “We hope that continued advocacy with policy makers on behalf of radiologists will influence the meaningful use criteria as they pertain to the practice of radiology.”