Two important pieces of national legislation stand to exponentially increase the dissemination of information technology (IT) into the healthcare space. The Health Information Technology for Economic and Clinical Health (HITECH) act is intended to foster programs to improve quality, efficiency and safety of healthcare delivery through better use of IT, while meaningful use (MU) incentivizes providers and hospitals to purchase and utilize electronic health records (EHR).
Hospitals throughout the U.S are now shopping for or deploying an EHR to comply with regulatory requirements and take advantage of the incentive programs administered by the Centers for Medicare and Medicaid Services (CMS) through MU. Even those intrepid early adopters of first-generation EHRs are finding themselves again having to commit time, resources and capital to choosing a replacement EHR to meet the new standards.
It would be short-sighted to think of an EHR as something for clinicians and less relevant to radiologists—nothing could be further from the truth. We sometimes forget who took many of the groundbreaking steps to develop many of the IT tools we take for granted today. While our clinical colleagues were still laboring with paper during the past two decades, we quietly transformed imaging services to filmless and paperless environments. In the transition, we learned how to manage enormous datasets and embrace the advantages that come from integrating related information systems—most notably, the radiology information system (RIS), PACs and speech recognition software for report generation. Each of these has evolved and has the capacity to serve as the primary workflow manager in a radiology department.
After many years of going through multiple purchasing cycles for IT products, radiologists have also become skilled at navigating the vagaries of IT vendor contractual negotiations and assessing product performance specifications. The selection, staging and deployment of an EHR requires a large team of administrative, provider and IT stakeholders. Radiologists may not fully realize the valuable skills they have to leverage in the complex process of purchasing and configuring an EHR.
Decision support (DS) is an additional software layer that operates in concert with a computerized provider order entry system to help guide more prudent decisions and better utilization of resources. Again, radiologists are best equipped to assess the DS tools offered by vendors, as well as enhancements that integrate radiology scheduling, billing and resource management. Only the responsible management of skyrocketing healthcare expenditures and evidence-based decision making will be rewarded in the accountable care models for reimbursement.
Imaging will always remain a primary tool in the diagnostic armamentarium, but in the near future only appropriate use and cost-effective imaging will be reimbursed. It is in the best interest of all radiologists to be among the integral players in the EHR selection process.
For more information on RSNA’s Informatics programs and tools, visit RSNA.org/Informatics.aspx.
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