Legislative impetus alone is not enough to connect medical images to EHR

Posted by Les Trachtman on Nov 14, 2014 11:51:04 AM

Learn the truth about connecting medical images to EHR

Within The American Reinvestment & Recovery Act (ARRA), the Health Information Technology for Economic and Clinical Health (HITECH) Act created the concept of meaningful use. The goal of the Act was to modernize the healthcare industry by promoting the use of interoperable Electronic Health Records (EHR).


The concept of meaningful use focused on five goals:

  • Improve quality, safety, efficiency, and reduce health disparities
  • Engage patients and families in their health
  • Improve care coordination
  • Improve population and public health
  • Ensure adequate privacy and security protection for personal health information


The HITECH Act was implemented in stages to enable a smooth transition to these new practices. Stage 1 is currently in place with Stage 2 adoption underway. Congress imposed carrot and stick incentives to accelerate adoption of these rules. If covered healthcare organizations comply early, they receive incentive payments from the Center for Medicare Services (CMS). Those that don’t are penalized with reduced reimbursements.


This set of incentives served too compelling for most healthcare professionals to ignore, especially in the already-squeezed reimbursement environment. Healthcare organizations raced to implement EHR systems, often blindly ignoring the program’s goals just to ensure the capture of incentives. Although the government achieved a predictably high participation with compliance, there is disagreement whether this legislation has moved us closer to achieving its stated priorities.


Which gets us to where we are today.

Most healthcare organizations have implemented some version of Electronic Health Record, yet few can access medical images from these systems. And while most physicians describe the need to see textual patient records together with medical images, Stage 2 Meaningful Use does not require a link between medical images and EHR.


Stage 2 Meaningful Use encourages the combined presentation of images and patient records, but only through a very watered-down option. To meet the medical image linking objective of meaningful use, organizations need as few of 10% of patient records to have access to their corresponding images. But even this choice is optional - organizations must choose three out of six potential menu objectives, and this is only one. For healthcare organizations with fewer than 100 patients having available images, this 10% threshold is removed entirely.


To satisfy Stage 2’s threshold, images may literally be scanned into a patient record. While this may put the physician on notice that an image is available for a particular patient, it is a far cry from actually being able to analyze the image in a purpose-built diagnostic medical imaging system.


So despite the stated desire of physicians to marry images with patient records, Stage 2 will instigate little progress towards this end. Something more drastic needs to occur to make retrofitting existing EHR systems with image access much more simple and inexpensive.


This is the first in a three part series on EHR + Medical Images. Next time, we'll discuss the failure of PACS and EHR communication and the straightforward solution to connect the two.

Topics: EHR + Medical Images, EHR + PACS, Stage 2

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