ImageGuide Background & Benefits
Data Elements & Submission

ImageGuide Background & Benefits

What is the ImageGuide Registry?

The ImageGuide Registry is the first cardiovascular registry of its kind, focusing on SPECT and PET imaging studies. The primary purpose of the registry is quality improvement, and it provides a fully integrated platform to seamlessly collect data in nuclear imaging labs to measure quality, safety, and efficiency.     
What are the benefits to participating in the ImageGuide Registry?
  • Gain access to benchmark reports and standardized performance data

  • Enhance patient care and improve lab efficiency

  • Successfully participate in regulatory programs and avoid negative payment adjustments on Medicare Part B services

  • Report on nuclear cardiology-specific performance measures under PQRS/MIPS

  • Demonstrate appropriate use of nuclear imaging tests to payers


What is the cost to participate in the ImageGuide registry?

For 2016, the annual cost to participate is $500/physician for ASNC members and $750/physician for non-members, but for a limited time all ASNC members can participate for free.  The cost of participation for 2017 forward has yet to be determined. 

What types of physicians are eligible to participate in the ImageGuide registry?

Any physician who interprets SPECT or PET nuclear cardiac imaging studies is eligible to participate in the registry.
Must I enroll 100% of the interpreting physicians in my practice/hospital in the registry?

It is not required that all physicians at a practice/hospital participate; a subset of physicians at a practice/hospital may enroll at any time.
Do I need IRB approval to participate in the ImageGuide Registry?

The Office for Human Research Protections (OHRP) has confirmed that institutions including practice groups, hospitals or other clinical care providers, that are providing data to a clinical data registry are not engaging in human subject research thus do not need IRB review and approval.  For more information, see the letter from the Physician Clinical Registry Coalition requesting clarifications by OHRP related to the application of the Common Rule to clinical data registries and the OHRP response to this letter.
As an international physician, can I participate in the ImageGuide Registry?

The ImageGuide Registry is only available to physicians practicing in the United States and its territories. In the future, ASNC will consider expanding ImageGuide participation to include international physicians.


Is the ImageGuide Registry a Qualified Clinical Data Registry (QCDR) for CMS’ Physician Quality Reporting System (PQRS) program?

ImageGuide has been approved as a QCDR for 2015 and 2016.  As part of the qualification process, ASNC submitted the performance measures it intended to include in the registry including measure title, description, denominator, numerator, denominator exceptions, denominator exclusions, rationale and supported evidence. ASNC also submitted other required documentation to CMS that includes the data collection methods, a data validation plan and an audit strategy.

As a QCDR, ImageGuide will allow participating physicians to report on performance measures developed specifically for nuclear cardiologists and receive credit under the PQRS program.  Successful participation in PQRS will allow physicians to avoid negative payment adjustments related to Medicare Part B claims in upcoming years.

What are the benefits of participation in the Physician Quality Reporting System (PQRS) Program?

In 2015, physicians who did not satisfactorily report data on quality measures will be subject to a 2% negative payment adjustment for all services rendered in 2017 for patients with Medicare Part B Fee for Service (FFS).  In 2016, physicians who do not satisfactorily report data on quality measures will be subject to a 2% negative payment adjustment in 2018.

The negative payment adjustment continues each subsequent year in the event a physician does not satisfactorily report data on quality measures in the preceding year.  Payment adjustments under the traditional PQRS program will sunset after 2018 with the implementation of the Merit-Based Incentive Payment System (MIPS) program, under which physicians will be subject to payment adjustments based on PQRS participation by the following schedule:

2019 -4%
2020 -5%
2021 -7%
2022 -9%
How many QCDR performance measures are included in the ImageGuide Registry, how many must I submit and what are they?

ImageGuide offers 13 nuclear cardiology performance measures for 2016. More information on measure specifications can be found here.

Physicians are required to submit data on at least 50% of the imaging studies performed on patients regardless of insurance payer (i.e., Medicare and non-Medicare).  Physicians are required to report at least nine measures covering at least three NQS domains. Of the nine measures, at least two must be outcome measures.  

Will I receive a negative payment adjustment on only the imaging studies performed on patients with Medicare Part B, or does the penalty apply to all Medicare Part B services rendered?

The adjustment applies to all Medicare Part B services rendered.  For example, a physician who did not successfully participate in PQRS in 2016, will be penalized 2% for all Medicare Part B services rendered in 2018. 
Does the ImageGuide Registry meet my Meaningful Use 2 (MU2) requirements?

The ImageGuide QCDR does not currently qualify for Meaningful Use 2 (MU2).  For a QCDR to qualify for MU2, the QCDR would have to be comprised of PQRS measures for which an Electronic Clinical Quality Measure (eCQM) specification has been created.  Currently the ImageGuide Registry consists of non-PQRS measures for which no eCQM specification exists.  As the ImageGuide Registry matures, it is our hope that the ImageGuide performance measures will become approved PQRS measures and CMS will create the required electronic specification for each measure.

Data Elements and Submission

What types of data are being collected in the ImageGuide Registry?
The registry measures performance areas such as appropriate use, report turn-around, study quality, and radiation dose.  ImageGuide also collects data on each participating nuclear lab, including staffing resources, practice/lab characteristics, accreditations/certifications, and imaging cameras used to perform the studies. Other meaningful statistics including rest/stress radiopharmaceuticals, types of stress tests, exercise protocols, and imaging protocols are also provided.

The ImageGuide registry includes approximately 132 data elements that directly relate to SPECT and PET nuclear cardiac imaging studies.  More information on ImageGuide data elements can be found here.  Please email imageguide@asnc.org for a copy of the complete data collection form.

Do all labs collect the same information?

All labs participating in ImageGuide will collect the same data elements with common definitions and permissible values.  A common set of data elements permits ImageGuide to provide meaningful performance measurement information to participating physicians and aggregated performance for all physicians participating in the registry.

Are there reports available to help analyze my data?

ASNC has contracted with FIGmd to validate and aggregate data, and to make reporting available to participating physicians and practice/hospital staff. Each participant has access to the ImageGuide dashboard, which shows individual physician performance, aggregate level practice/hospital performance, and the performance of each practice/hospital office location.  The dashboard also allows the performance of physicians, practices/hospitals, and office locations to be calculated and trended over time.  This functionality will be continually enhanced as new performance measures are added and other non-performance measure related statistics are requested by the provider community. 

How do I collect and submit data to the ImageGuide Registry?

Data can be collected and submitted to the registry in one of three ways:
Web-based Data Collection Tool

ImageGuide has developed a data collection tool for institutions to enter imaging study data directly into the registry in the event they are not using reporting software that contains all ImageGuide data elements. ASNC estimates each imaging study will take approximately 2-3 minutes to enter into the web, and staff/support personnel may be able to assist with data entry.
ASNC Certified Reporting Vendor

ASNC has partnered with three reporting vendors, INVIA (Corridor4DM), Cedars-Sinai (Cardiac Suite), and Syntermed (Emory Cardiac Toolbox), to collect all required data elements and provide a data export/transmission of the elements to the registry.  ASNC certifies each reporting vendor to assure the software contains all data elements as defined in the data dictionary, the data submission file conforms to ImageGuide specifications and the data can be successfully transmitted and loaded into the registry.

Please refer to the ImageGuide enrollment page of the ASNC website for more information on each certified vendor.

Systems Integrator

In the event that lab is using its own custom imaging reporting application or is using software from a vendor that has not partnered with ImageGuide, it may be possible to automatically extract and submit data from your EHR/EMR/Imaging System to the registry with assistance from FigMD.  If you would like to explore systems integration for your institution, please complete our technology questionnaire after enrolling through the sign-up portal and return to imageguide@asnc.org to see if you qualify for this data submission method.

Must I use an ImageGuide certified Reporting Vendor to participate in the registry?

No.  Labs may use the ImageGuide web-based data collection tool to collect and submit data to the registry, or you may qualify to use a Systems Integrator to extract, format and transmit your data to the registry on your behalf.

If you have any questions about the ImageGuide Registry, or would like a consultation on which data submission method is best suited for your institution, please email ImageGuide@asnc.org.