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A digital-based specialty deals with EHR adoption

by Loren Bonner, DOTmed News Online Editor | February 01, 2013
From the January/February issue of HealthCare Business News magazine

As you may have gleaned from our online news the past few weeks, industry updates about meaningful use and related health IT issues have been making headlines.

But one question is still gnawing at me after talking to several industry experts over the past few weeks: Do radiologists really have an upper hand in adopting electronic health records because of the digital nature of the specialty? Or more to the point: Has the federal incentive program-which is doling out $6.6 billion in payments to eligible participants over the next few years to push the transition from paper records to EHRs-made it more difficult for radiologists to benefit from the program?

Although the incentive program was not included directly in President Obama's health care reform law, rather it was established under American Recovery and Reinvestment Act he signed into law in 2009, broadly speaking, I'd say it's still in line with the overall goals of health care reform: supporting primary care.

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Recent reports seem to confirm this as well. A 2012 survey from the Commonwealth Fund found 69 percent of primary care doctors are using EHRs. Several have also taken advantage of regional extension centers to facilitate the adoption. "Many believe the government's incentive program and funding of the regional extension center-which are helping to train smaller practices - to have helped boost small practitioners' confidence," stated a recent blog post from the consortium of U.S. Medical Billers and Coders.

The group also gives credit to EHR vendors, who seem to have shifted their focus to smaller segments.

I spoke with Michael Peters, director of regulatory and legislative affairs at the American College of Radiology, for a story about an update to a rule that applies to radiologists who might be eligible for a hardship exception under meaningful use stage 2 rules. He said that while the program is applicable to all eligible physicians-including radiologists-there are additional hurdles for the specialty due to their workflow and interaction with patients, which requires more effort to satisfy meaningful use than say, a primary care physician or someone who fits more naturally with the requirements of the program. Nonetheless, he said, some radiologists are complying and others are facing barriers.

On a more positive note, according to new research I wrote about online recently from the Harvey L. Neiman Health Policy Institute, a new American College of Radiology think tank, radiologists were more likely to meet Medicare Physician Quality Reporting System (PQRS) requirements-24 percent qualified verses 16 percent of other providers. Dr. Richard Duszak, chief executive officer and senior research fellow there, told me that he thinks radiology, being a digital-based specialty and having "embraced the EHR more substantially and earlier," has been advantageous to other practices that are still paper-based, and could be a reason for radiology performing better than other specialties in this regard (the first stage of PQRS incentivize physicians with bonuses, but the next will penalize those who don't meet requirements).

To get back to that question that has been gnawing at me, we'll have to wait and see if meaningful use stage 2 and subsequent rules will do enough to capture what radiologists need to successfully implement EHRs into their practice.

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