Stage 2 Meaningful Use Proposal Includes Imaging

After being left out of the first phase of the meaningful use program, medical imaging was included in the proposed Stage 2 rule CMS and the Office of the National Coordinator released last week. Industry leaders are cautiously optimistic about how the rules will affect radiology, but they caution that providers shouldn’t act yet in response to the proposal.

Set to take effect in 2014, Stage 2 is considered by healthcare leaders to be a step toward a standards-based health information exchange, and officials announced imaging will also be included in the 2014 proposed rule for electronic health record (EHR) certification requirements. Providers who meaningfully use EHRs, based on the guidelines, qualify for $44,000 in federal incentive payments.

However, there could be some wiggle room for how strictly radiologists will need to adhere to those guidelines.

“The good news is that there’s mention of potential concessions for hospital-centric eligible professionals,” said Keith Dreyer, DO, chair of the American College of Radiology (ACR) IT and Informatics Committee-Government Relations Subcommittee and radiology vice chair at Massachusetts General Hospital. “It shows that the agencies have really paid attention to the uniqueness of specialties, such as radiology, and they are understanding that some challenges will exist when we try to comply.”

For example, many hospital-based providers are not included in and have no influence over their facility’s information technology decisions. This position could render them unable to comply with some meaningful use requirements. In the Stage 2 proposed rule, CMS has granted these practitioners an exemption.

Many of the ACR’s requests were included in the proposed rule, including a discretionary menu targeted toward diagnostic image accessibility in EHRs. Under Stage 1, in addition to a providers could choose five out 10 options from a list of requirements in order to meet certification. Stage 2 is similar. However, it offers fewer options - providers must choose three of five requirements. The proposed rule also includes ACR’s recommendation for radiology-relevant clinical quality measures, and more flexible definitions of patient encounters and of certified EHR, among other recommendations.

“We certainly feel positive. While this isn’t ideal, there’s room for improvement,” said Michael Peters, ACR director of legislative and regulatory affairs, adding ACR plans to ask for some changes to wording included in the proposed rule. “There’s going to be compromise in any rulemaking, and from the ACR’s perspective, we’d like to see more specific mentions of clinical decision support for radiologists, but things are headed in the right direction.”

However, it’s important to remember, Peters said, that these are not the final rules. Providers shouldn’t develop or implement any plans, and vendors shouldn’t do any product launches on the basis of these rules. The 60-day comment period began after the proposed rules were published, and the ACR anticipates the final rule will be released later this fall.

Even still, the proposed rules have elicited a positive reaction from vendors, as well. According to a written statement, John Glaser, PhD, chief executive officer of Siemens Health Services Business Unit, the company plans to work closely with customers to explain the rules and their ramifications, as well as discuss how the company’s services can support meaningful use efforts.