AHRA’s annual meeting was held in Nashville, Tenn., in 2016, but this year, it’s trading in cowboy boots and country music for sunshine and that cartoon mouse with the famous laugh. AHRA President Jason Newmark, CRA, took a break from making final preparations for AHRA 2017 in Anaheim, Calif., to speak about some of the biggest issues impacting both the present and future of radiology.
As you look over the radiology landscape in 2017, what do you think some of the biggest stories of the year have been so far? What subjects have you been paying extra close attention to this year?
First would be anything that has to do with clinical decision support (CDS) tools and this new legislation that, theoretically, everyone is supposed to have an automated CDS system up and running by January 2018. What’s interesting is that legislators haven’t finished nailing down all the details about exactly what is required. For example, the CDS system will provide a number that can go on a claim form, but they haven’t explained where that number goes on the claim and some of the other fine details about how all the data flows. We just completed a survey of AHRA members and received a couple hundred responses. The scary truth is that more than half of the respondents had not even started implementing their CDS systems. This is a hot topic for me. I think it’s a wonderful idea and the tool will assist with improving the appropriate use of imaging services, but it’s a logistical challenge when you start to implement these systems.
Another big story is the proposed reimbursement cuts for sites still using analog (surprisingly, there are still a lot of people printing film) and/or CR technology as of January 2018. The new legislation requires us to go from analog and/or CR to DR or face reimbursement penalties that will increase year over year. This creates an enormous challenge for organizations—especially those like mine, where we have a lot of equipment that is still CR. We will need to invest a tremendous amount of time, resources and capital to upgrade and/or replace this equipment or accept reduced reimbursement. It’s another one of those situations where legislators have an idea and try to promote enhanced quality of care, but I am not sure they understand the challenges this places on organizations, specifically around coming up with the capital.
Another big story is anything related to MACRA or MIPS with radiology. Again, it’s a great idea and I would much rather be measured on the true quality and value of the services we provide, but it creates a lot of question marks. What exactly does this legislation require? How do we pull and present necessary data? We’re trying to pay a lot of attention to this legislation and to collaborate with the American College of Radiology as closely as possible. We also have our own AHRA Regulatory Affairs Committee that is sharing information with our members about what the requirements of this legislation will mean on a day-to-day basis.
Data analytics in general is the last big topic that I’m watching and working with my teams on as much as possible. There’s so much data out there, and you hear a lot of vendors saying data, data, data, but what does that really mean? Just pulling together data is not enough—it has to be in a format that can truly be useful and should help us assess, enhance and promote the value of the services imaging provides to the overall care continuum. I think the magic bullet here will be when someone figures out how to collate and present this data into something truly useful.
What are some of the biggest issues or problems leaders in medical imaging face on a day-to-day basis?
I see two main issues. The biggest issue is that, for the first time in a long time, we are being challenged to promote the value of imaging. We don’t want to be commoditized—and I think a lot of patients and referrers assume, “Oh, I can get an X-ray here or an X-ray there, it doesn’t matter, every technologist and radiologist is the same.” I don’t want to say we are being taken for granted, but we have to be careful we don’t let that happen. We need to find a way to be much, much more involved with the care continuum; not just report generators. One of the biggest challenges is making sure people appreciate the true value of the services we provide: Who we are … the skills/knowledge required to perform exams …