ACR Economics Update:The Future of Imaging Informatics

Speaker NameTitle

What’s Driving Imaging Informatics?

Embed video clip of Dr. Geraldine McGinty

What’s Driving Imaging Informatics?

The CMS and HHS agenda: Drive reimbursement to primary care Reduce unit reimbursement for imaging to manage

utilization Reduce overall spending Respond to “outside” pressure (e.g., MedPAC)

Payment models have determined our business models

Business models have determined our innovation Incentives fuel our innovation Resulting technologies based on fee-for-service

Our Current State

Teleradiology Created secure access for remote radiologists Initially created to improve productivity and

convenience Serves to further reduce costs Unintended consequence

Our Current State

Our Current State INNOVATION PRODUCTIVIT

YPROFITABILIT

YPERFORMAN

CE PRESENCE

CURRENT STATE

RIS PACS

SPEECH RECOGNITION

ADV VIS, 3D, CAD IMAGE

DISTRIBUTION TELERADIOLOGY

FUTURE

STATE

IMAGE SHARING STRUCTURED REPORTING

COMMUNICATION TECH

IMAGING CDS IMAGING EHR IMAGING PHR

Productivity Profitability Performance Presence

Current

The Future of Imaging Informatics

• Health and imaging reform• US healthcare represents 17% of the GDP• Cost is a primary concern for all health reform• CMS exploring fee-for-service alternatives• Shifting of risk from payers to providers

FIVE FUNDAMENTAL GOALS

Meaningful UseImprove Quality, Safety, Efficiency

Engage Patientsand Families

Improve Care Coordination

Improve Public & Population Health

Ensure Privacy and Security

Stage 1 Core Order Entry Drug Interaction Problem Lists e-Prescribing Medication List Allergy List Demographics Vital Signs Smoking Status Quality Measures Decision SupportStage 1 Menu Drug Formulary Lab Test Results Patient List Patient ReminderStage 2 Menu Progress Note Family History Imaging Results

Stage 1 Core eHealth Info Copy Clinical SummaryStage 1 Menu Electronic Access Educational InfoStage 2 CoreSecure Messaging

Stage 1 Core Electronic Exchng

Stage 1 Menu Reconcile Meds Transition of Care

Stage 1 Menu Immunizations Syndromic DataStage 2 Menu Cancer Registry Specialty Registry

Stage 1 Core Protect ElectronicHealth Information

25 OBJECTIVES AND MEASURES: STAGE 1

33 OBJECTIVES AND MEASURES: STAGE 2

Meaningful Use (MU)A voluntary CMS incentive program to promote use of Certified Electronic Health Record Technology (CEHRT) to improve the safety, quality and cost of health care.

Meaningful UseRADIOLOGISTS

– NEARLY ALL ARE ELIGIBLE FOR THE PROGRAM

– COMPLIANCE CAN STILL BE CHALLENGING FOR MANY

RADIOLOGISTS

2011 2012 41275

0%5%

10%15%20%25%30%35%

Attested RadiologistsAttested Physicians

0.9% 4.5% 7.8%6.4%

26.7%32.2%

(168,112 / 521,600)

(2,108 / 27,000)

PROVIDERS RECEIVING EHR PAYMENTS AS A PERCENTAGE OF THOSE ELIGIBLE

Meaningful UseSTAGES OF MEANINGFUL USE

STAGE 1

ORGANIZEDATA

2013 2014 20152012

HE

ALT

H R

EC

OR

D R

EF

OR

M

TWO YEARSTWO YEARS

2016 2017

IMPROVE PROCESSES

STAGE 2 IMPROVE OUTCOMES

STAGE 3

FUTURE STAGES

TWO YEARS

Ordering Physician MU Expectations of You

• IMAGE ORDERING MEASURE– USE CEHRT TO ORDER > 30% OF IMAGING EXAMS

• IMAGE RESULTS MEASURE– USE CEHRT TO RECEIVE > 10% OF IMAGING RESULTS (IMAGES!)

IMAGE ORDERING AND RESULTS OBJECTIVES (STAGE 2)ORDERING PHYSICIANS (2014+)

ORDERINGPHYSICIAN FACILITY

IMAGING

PROVIDER FACILITY

ORDER

CEHRT

ORDERINGPHYSICIAN FACILITY CEHR

T

IMAGING

PROVIDER FACILITY

ORDER

ACR Imaging 3.0 Technology

Providers Payers

FEDSMEMBERS

INDUSTRY

Technology Vendors

IMAGING 3.0 TECHNICAL FRAMEWORK

ACR

ENABLING PLATFORM

INDUSTRYACCESS

APPLICATIONS

Imaging 3.0 Technical Framework

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IMAGING STANDARDS

ACR CONTENT

APPLICATION SHARING

ACR CONTENT

IMAGING STANDARDS

APPLICATION SHARING

IMAGING 3.0 TECHNICAL FRAMEWORK

Our Future State INNOVATION PRODUCTIVIT

YPROFITABILIT

YPERFORMAN

CE PRESENCE

CURRENT STATE

RIS PACS

SPEECH RECOGNITION

ADV VIS, 3D, CAD IMAGE

DISTRIBUTION TELERADIOLOGY

FUTURE

STATE

IMAGE SHARING STRUCTURED REPORTING

COMMUNICATION TECH

IMAGING CDS IMAGING EHR IMAGING PHR

Productivity Profitability Performance Presence

CurrentFuture

Our Future State

Productivity Profitability Performance Presence

CurrentFuture

• Healthcare reform is changing how we practice

• IT innovation is equally transformative• Imaging 3.0 is serving as our framework• Creating IT tools centered on this framework• Educating our profession about new

paradigms• Participating with Feds and Industry to

manage change

The Future of Imaging Informatics

Imaging 3.0 – Preparing for the Future

www.acr.org/Advocacy/Economics-Health-Policy/Imaging-3