Improving health care quality while simultaneously reducing cost has become a high priority of health care reform. Informatics is crucial in tackling this challenge. The American Recovery and Reinvestment Act of 2009 mandates adaptation and “meaningful use ” of health information technology. In this review, we will highlight several areas in which informatics can make significant contributions, with a focus on radiology. We also discuss informatics related to the increasing imperatives of state and local regulations (such as radiation dose tracking) and quality initiatives.
There is no denying that the health care system of the United States is facing a crisis. On one hand, the United States spends more of its gross domestic product on health care than any other nation in the world, according to the World Health Organization (WHO)’s annual compilation of health-related data for its 193 member states . On the other hand, WHO ranked the US health care system 37th in overall performance among its 191 member states in 2000 .
Improving health care quality while simultaneously reducing cost has become a high priority. There has been a push for Accountable Care Organizations, which are groups of health care providers whose reimbursement is tied to quality improvements and cost reductions . The practice of radiology also faces increasing regulations and monitoring for quality improvements, such as the Mammography Quality Standards Act and Program, which require monitoring of radiation dose.
Informatics is crucial in tackling the challenge of improving quality and curbing cost. Several recent legislations focus on health information technology. The American Recovery and Reinvestment Act of 2009 includes $25.8 billion for health information technology investments and incentive payments. The Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act of 2009, promotes adaptation and “meaningful use (MU)” of health information technology. It mandates that incentives be given to Medicare and Medicaid providers not simply for adaption of Electronic Health Record (EHR) but specifically for meaningful use of EHR technology.
Accordingly, definition of MU in EHRs has been an important issue. In July 2010, the Department of Health and Human Services released the definition for stage 1 (of ultimately three stages) of MU, intended for deployment in 2011 and 2012. Definitions for future stages (stages 2 and 3) are under discussion .
The Medicare and Medicaid EHR Incentive Programs, administered by the Centers for Medicare and Medicaid Services, provide a significant financial incentive for eligible professionals and hospitals to meet the MU criteria. Medicare incentive program awards $44,000 over 5 years for eligible health professionals and a $2 million base payment for eligible hospitals and critical access hospitals (CAH). As anticipated, the incentive payments will later be replaced by penalties for noncompliance; in 2015 and later, eligible Medicare professionals, eligible hospitals, and CAHs that do not successfully demonstrate MU will have a payment adjustment in their Medicare reimbursement. Medicaid offers a similar EHR incentive program, with $63,750 to eligible professionals and $2 million base payment to hospitals.
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Decision support systems
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CPOE-DS
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Decision support for radiology interpretation
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Informatics to facilitate data mining
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Informatics to facilitate data sharing
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Tracking medical radiation doses
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Controlled terminologies and structured reporting
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Business intelligence
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Conclusions
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