Radiology Workflow, Data Transmission and Storage in the Age of Meaningful Use

Doug Rufer, Director Clinical Operations and Business Strategy, Healthcare Information Solutions, Carestream Health

Meaningful Use has been a moving target in 2011 and we see signs that there will be no slowing down in 2012.  Keeping abreast of changes and sifting through misinformation to determine your organization’s strategy can be a continual challenge—but one that is winnable.

Radiology workflow, IT system data transmission and storage, and the importance of using certified technology – either modular or complete – are often overlooked elements of the overall Meaningful Use process.

Carestream's Vue RIS received modular certification for both Eligible Hospitals (EH) and Eligible Providers (EP) in October.

Once your organization decides it will comply with Meaningful Use, your journey begins with:

• Determining the measures you will track by eligible provider
• Evaluating your IT solutions and updating your technology to comply with all measures
• Discussing  with your supplier their strategy for MU compliance and any potential gaps

As you move forward, you must look at the impact on specialties and the operations of your radiology department to chart the best course for success.

Understand the Measures

The first step is understanding your workflow and how and where data will be captured for a complete picture of how compliance will affect your radiology operations.  Much of the data you are now required to track, monitor and report against for meaningful use measures is data that has not traditionally been captured by radiology departments—and some may argue that such data is outside the scope of radiology.  However, having this data may be useful.  For example, recording smoking status may not, at first glance, be relevant to radiology.  But this information may become VERY important if a radiologist is reviewing a chest x-ray and sees an obscure nodule. Understanding more about a patient’s history could impact diagnosis.

Plan for Change

The challenge for radiology is where data is captured.  For EACH visit, information such as BMI, blood pressure, etc. must be captured, recorded and possibly transmitted to other IT systems or directly to the CMS, based on the measures you track.  Since this responsibility has traditionally fallen to a patient’s physician, the requirement for radiology to capture that data can be a workflow burden for many facilities.

Answering the questions below will help you plan for the full impact and ease the workflow adjustments of meaningful use compliance:

• Where in the workflow process will we capture each measure we will submit?
• What impact will capturing the data at that point in the process have on our overall operations and staff?
• Will we need to increase our exam time slots when scheduling studies?  If yes, by how much?
• Will we need to hire additional resources to capture the necessary data?
• How will this impact patient wait times?
• How will we ensure staff complies with capturing this required data for reporting?
• How will we explain to patients that we need to capture this data during each visit?
• How are we going to handle high throughput modalities (like mammography screening)?
• Who will be required to enter data?
• Who will monitor and provide daily checks and balances to ensure compliance?
• What information will we need to send to other certified IT systems?
• Will we directly submit data from our RIS to the CMS; to an EMR; or both?
• What is the overall cost to our organization to capture this additional information?
• How can we minimize the financial impact?

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