said that doing “something” vs. “nothing” is usually the right choice when
faced with a challenge. Let’s examine this axiom from a Meaningful Use (MU) perspective.
The American College of Radiology (ACR) just released some very useful information on MU. For those that haven’t seen
it, you can read it here:
story, opportunities to “reduce the denominator” exist for radiologists to meet
the MU objectives. If that term evokes too many bad memories of math class,
here’s another way to look at it.
denominator in MU speak refers to the number of patients that you need “in
scope” to attest to certain objectives. It so happens that the same objectives
are the very measures that are giving many radiologists heartburn, and they
relate to capturing the extra data about the patient. The data in question are
things like smoking status, active medications, medication allergies and so on.
opportunity is directly linked to what many refer to as the “as seen by EP”
language in the MU measure specifications and is quoted here:
where the EP and the patient have an actual physical encounter with the patient in which they render any service to the patient should
be included in the denominator as seen by the EP. Also a patient seen through
telemedicine would still count as a patient “seen by the EP.” However, in cases
where the EP and the patient do not have an actual physical or telemedicine
encounter, but the EP renders a minimal
consultative service for the patient (like reading an EKG), the EP may choose
whether to include the patient in the denominator as “seen by the EP” provided
the choice is consistent for the entire EHR reporting period and for all
relevant meaningful use measures. For example, a cardiologist may choose
to exclude patients for whom they provide a one-time reading of an EKG sent to
them from another provider, but include more involved consultative services as long as the policy is consistent
for the entire EHR reporting period and for all meaningful use measures that
include patients “seen by the EP.” EPs who never have a physical or
telemedicine interaction with patients must adopt a policy that classifies at
least some of the services they render for patients as “seen by the EP,” and
this policy must be consistent for the entire EHR reporting period and across
meaningful use measures that involve patients “seen by the EP” – otherwise,
these EPs would not be able to satisfy meaningful use, as they would have
denominators of zero for some measures.
short, so long as you can consistently, and programmatically identify a set of
exams for which every radiologist who is attesting has “at least one” exam
where they “see” the patient, you get to pick these exams.
In terms of
workflow impact, if you’re a practice that reads 700,000 procedures per year,
rather than entering the above data for every procedure (or “encounter” in MU
speak), only a small subset of these encounters have to have data entry. Rather
than ask every patient if they take any medication, you can ask say, only 4,000
of these patients.
In the case
of MU, doing nothing is in fact the right choice, and, perhaps most
importantly, the ACR agrees.
Biography: Robert “Bob”
Cooke is a corporate strategist with over 20 years of experience in the medical
imaging informatics and equipment market, and is currently working with a number of small companies and
start-up ventures. He is the former former Senior Vice President
of Sales and Marketing at Fujifilm Medical Systems. Bob was also the Vice President
and Global General Manager at Agfa Healthcare. Bob’s expertise is in creating growth, designing new business
ventures and developing and managing strategic partnerships.