As discussed in this paper, the proposed Medicare Access and CHIP Reauthorization Act (MACRA) legislation has some specific measures that relate to Radiology imaging exams and their diagnostic results. In some scenarios, an Image Sharing service is likely required to meet these measures.
Understanding MACRA, and how imaging professionals can use available tools to assist their organization meet the program’s requirement, will be important in the coming months and years.
As covered in this paper, professionals working in Diagnostic Radiology should be aware of two of the nearly 300 total MIPS Quality Category Measures in particular. Both are related to “Optimizing Patient Exposure to Ionizing Radiation: Computed Tomography (CT) Images Available for Patient Follow-up and Comparison Purposes” and “Search for Prior Computed Tomography (CT) Studies Through a Secure, Authorized, Media-Free, Shared Archive.”
In the ACR resources cited in the article, there are other measures that apply to Interventional Radiology and Radiation Oncology, and ones that apply to traditional Diagnostic Radiology, but do not apply directly to the use of Image Sharing.
Essentially, these translate to the ability to make CT images available to external physicians and to search for available CT exam images before performing a CT exam. Of course, as a measure, it also requires that these activities are recorded and expressed as a percentage of total CT exams.
If organizations are seeking to meet the six MIPS Quality Category measures required of participating physicians and physician groups, Radiology professionals who can address these two measures may contribute significantly to MACRA compliance.
To address the “nonaffiliated external healthcare facilities or entities on a secure, media-free, reciprocally searchable basis” language of the measure, the participating entity needs to report the measure for exams that are not managed as part of the enterprise, and do so without using media. This would include, for example, outside exam images not on CD. Cloud-based Imaging Sharing network services are designed for this type of access and a logical choice for helping to address the measure.
Methods to report on transaction statistics of searches for external CT exams prior to performing a CT exam, or “percentage of final reports for computed tomography (CT) studies… which document that... image data are available” will ease the burden of reporting. As Image Sharing networks typically provide usage analytics and reporting, this may be valuable in report data preparation.
As the paper covers, there are some measures to consider, related to Care Coordination and Beneficiary (Patient) Engagement, under the Clinical Practice Improvement Activities (CPIA) category, that may indirectly benefit from Image Sharing.
Imaging professionals are well advised to educate themselves on the reporting requirements of measures in the MACRA program, especially those that relate to medical imaging procedures and medical records (of which imaging is a part).
For enterprises involved in imaging information exchange through a “secure, media-free, reciprocally searchable basis,” and a “secure, authorized, media-free, shared archive,” understanding how their Image Sharing service can help meet the reporting requirements of the measures is likely worthwhile.
About the Author
Don K. Dennison has worked in the medical imaging informatics industry for over 14 years. Currently serving as a consultant, he is a speaker and panelist on topics ranging from medical imaging record interoperability, integration of imaging data within the EMR, multi-facility integration and others. Don currently serves on the Board of Directors of the Society for Imaging Informatics in Medicine (SIIM) and chairs the ACR Connect committee for the American College of Radiology (ACR).