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MGH/PHS has licensed technology to, receives royalties from and/or has financial interests in: LifeImage, Inc. Nuance, Inc.

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Presentation on theme: "MGH/PHS has licensed technology to, receives royalties from and/or has financial interests in: LifeImage, Inc. Nuance, Inc."— Presentation transcript:

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2 MGH/PHS has licensed technology to, receives royalties from and/or has financial interests in: LifeImage, Inc. Nuance, Inc.

3 Societies and Organizations ACR Chairman, IT Government Relations Cmte Co-Chairman, Informatics Cmte Co-Chairman, Clinical Decision Support Cmte Meaningful Use Presenter RSNA Chairman, IT Government Relations Cmte Member, Informatics Cmte Meaningful Use Presenter ABR Member, ABR IT Advisory Committee RBMA Meaningful Use Presenter RadiologyMU.org Meaningful Use Advisor Meaningful Use Presenter

4  MGH Experience  EMR  Imaging Integration  IMR – Imaging Medical Record  Meaningful Use for Radiology  ACR Message to Federal Agencies

5 Use EMR as a context platform for communication  Hospital Distribution of Images

6 PACS EMR Adsdf ald fsf ff Adf asfaf asdfdf Th rie his son wo Jswher wih sosfn Thwi neo whos m Haf fueowh oehw Hwe rnie nroeon New inwripwpw Nf fjskd oer o erj

7 Use EMR as a context platform for communication  Hospital Distribution of Images  Enterprise Distribution of Images  Multiple PACS to Enterprise EHR

8 PACS EMR Adsdf ald fsf ff Adf asfaf asdfdf Th rie his son wo Jswher wih sosfn Thwi neo whos m Haf fueowh oehw Hwe rnie nroeon New inwripwpw Nf fjskd oer o erj Enterprise EMR with MPI PACS Adsdf ald fsf ff Adf asfaf asdfdf Th rie his son wo Jswher wih sosfn Thwi neo whos m Haf fueowh oehw Hwe rnie nroeon New inwripwpw Nf fjskd oer o erj

9 Use EMR as a context platform for communication  Hospital Distribution of Images  Enterprise Distribution of Images  Multiple PACS to Enterprise EHR  CPOE for Radiology  CDS for Radiology Ordering

10 RIS EMR Adsdf ald fsf ff Adf asfaf asdfdf Th rie his son wo Jswher wih sosfn Thwi neo whos m Haf fueowh oehw Hwe rnie nroeon New inwripwpw Nf fjskd oer o erj Medical Imaging Clinical Decision Support ORDER IMAGING… PACS

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12 19% Decrease (2005 – 2008)

13 Use EMR as a context platform for communication  Hospital Distribution of Images  Enterprise Distribution of Images  Multiple PACS to Enterprise EHR  CPOE for Radiology  CDS for Radiology Ordering  Foreign Image Import – Physical Media  Extra-Enterprise Image Sharing

14 Physician Desktop Physical Media Based Exchange Category I Radiology image CD of patient with an MRN Category II Non-Radiology image CD of patient with an MRN Category III Any image CD of patient without an MRN LifeIMAGE PACS EMRLI I II III RSNA-NIBIB Image Sharing Project Hosp 1 Hosp 2 Hosp n PHRs Standards Based Exchange To Other Providers To Patients

15  MGH Experience  EMR  Imaging Integration  IMR – Imaging Medical Record

16  Standalone Platform  Radiology manages entire system  Authentication, HIPAA, group privileges  Session level security  Browser and mobile device based  External Access to Imaging Services  Exam Ordering, Scheduling, CDS, Authorization  Critical Communication System  Report and Image Distribution

17 PACS Hospital Dept Imaging Center Imaging Center Imaging Center Imaging Center Imaging Center External EMR 1 External EMR n RIS MGH EMR Medical Imaging Clinical Decision Support Imaging Medical Record

18  MGH Experience  EMR  Imaging Integration  IMR – Imaging Medical Record  Meaningful Use for Radiology

19  Information Technology  MGH Developed  Complete EHR Certification Process

20 Q Q Q July 2010 Aug 2010 Sept 2010 Notice of proposed rule making 60 day comment period Review Gap analysis based on proposed rule Completed Final LMR Gap Analysis LMR Certification Timeline and Milestones Version 2.0 August 2010 LMR Spring 2011 Release LMR Fall 2010 Release We are here LMR Exec. Approval for Cert. projects Define reasonable approaches to all LMR MU gaps Oct 2010 Nov 2010 Dec 2010 Jan 2011 Feb 2011 Mar 2011 Apr 2011 May 2011 Final Rules Published Insight into ONC-Authorized Testing and Certification Body LMR Certification Best case scenarioWorst case scenario

21  Information Technology  MGH Developed  Complete EHR Certification Process  Vendor Components  Modular EHR Certified  Internal Support for EP Meaningful Use

22 1. Master e-prescribing (eRx)  CPOE (30% medication orders)  Transmit prescriptions electronically (40%)  Implement drug-drug / drug-allergy (attest)  Maintain active medication list (80%)  Implement drug Formulary (attest) Core 1 Menu 1 2. Leverage Care Team Record demographics (50%) Record vital signs (50%) Record smoking status (50%) Provide patients with an electronic copy of health info. (50%) Provide clinical summaries for each office visit (50%) Leverage Enterprise Application Implement 1 clinical decision support rule (attest) 1 - test of EHR capability to exchange key clinical information (attest) Capability to submit immunization to immunization registries (attest) Capability to submit electronic syndromic surv. data (attest) Incorporate clinical lab test results unto EHR / structured data (40%) Generate Lists of patients by specific conditions (attest) Focus on Structured Data Elements Maintain problem list (80%) Maintain active medication allergy list (80%) Quality Reporting (report measures) Practice Assessment Work Conduct security risk analysis (attest) IS and MGH/MGPO Practice Staff Eligible Providers

23  Information Technology  MGH Developed  Complete EHR Certification Process   Vendor Components  Modular EHR Certified  Internal Support for EP Meaningful Use  Radiologists don’t directly input data to the EMR  Voice => Reporting System => RIS => EMR  Need to create a parallel system for radiologists to be seen as other EPs by the EMR

24 MGH EPs /Other Care Providers Rad 1Rad 2Rad n Reporting System (Voice Recognition) RIS EMR MU Data Aggregation MU EP Dashboard MU Reporting to CMS Interpretations = Patient Encounters

25  MGH Experience  EMR  Imaging Integration  IMR – Imaging Medical Record  Meaningful Use for Radiology  Messages to Federal Agencies

26  Include Medical Imaging into HITECH care goals  Quality, Safety, Cost, Outcomes  Use Meaningful Use constructs when possible  Create a distinction between:  Medical Imaging Creators  Medical Imaging Consumers

27  For Medical Image Consumers  Images included in MU definition for ‘exam results’  EMR, PHR, PHI Sharing  Require electronic ordering of Imaging  Require ‘electronic’ not paper to imaging department  Clinical decision support of Imaging  Separate from disease centric, order sets, drug-drug

28  For Medical Image Creators Create CQM specific to these EPs  Critical communication management  Urgent Notification, Recommendation Follow up  Require Report and Image Connectivity  To EHR and PHR  Provide Imaging CPOE and CDS  Radiation Dose Registry Compliance  Archival, Display, Access requirements  Relax the requirement to purchase systems that measure what EPs are excluded from.

29  Embrace Clinical Decision Support for Imaging  Demonstration Project for Imaging CDS  Support Initiatives for CDS Rule Sets  National, Transparent, Standard, Medical Societies  Consider payment reform based on CDS

30  Radiation Dose Registry  Patient Centric Exposure Monitoring  Image Storage and Access Requirements  Consumer based mobile visualization  iPhone, iPad

31  Demonstrate value of existing technologies  CDS, Image Sharing, Critical Comm, Consumer Access  Promote standardization of existing technologies  Foster a common understanding of Imaging  Throughout various governmental agencies  Throughout Congressional oversight committees  Throughout the White House and OMB

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