This is a first pass at trying to catalog the changes in the final rule. Your comments and observations are welcome!

CPOE

Preliminary rule

• Practices: use CPOE for orders involving medications, laboratory, radiology, and referrals.
  Hospitals: medications, laboratory, radiology, blood bank, PT, OT, RT, rehab, dialysis, consults, and discharge and transfer.
  Orders do not have to be sent electronically to the fulfilling department (lab, pharmacy, etc.)
  Practices must enter 80% of their total orders directly by the clinician into the CPOE system. Hospitals must have 10% of all orders entered by CPOE.

Final rule

• For practices and hospitals: more than 30% of unique patients with at least one medication in the medication list have at least one medication ordered through CPOE. The denominator is no longer total orders generated. Lab and diagnostic orders eliminated from the CPOE requirement. Any licensed professional can enter the order. ED orders count toward the inpatient total for CPOE.

Clinical Checking of Orders

Preliminary rule

• Real-time screening (drug-drug interactions and drug-allergy contraindications), formulary check, user ability to maintain screening rules, track user responses to alerts.

Final rule

• The EP/eligible hospital/CAH has enabled the drug-drug, drug-allergy, and drug-formulary check functionality for the entire reporting period. Any EP who writes fewer than 100 prescriptions during the EHR reporting period is exempt.

Problem List

Preliminary rule

• Longitudinal current and active diagnoses coded in ICD-9-CM or SNOMED CT.
  80% of unique patients must have at least one coded problem/diagnosis, with “none” being an allowed entry (hospitals and practices).

Final rule

• At least 80% of patients have at least one entry or an indication that no problems are known. Data must be recorded as structured data . Coding doesn’t have to be done concurrently – the codes can be added later by anyone.

E-Prescribing

Preliminary rule

• Practices only.
  Must send 75% of non-controlled substance prescriptions electronically.

Final rule

• Threshold dropped from 75% to 40%

Active Medication List

Preliminary rule

• 80% of unique patients must have at least one coded entry, with “none” being an allowed entry (hospitals and practices).

Final rule

• Unchanged.

Medication Allergy List

Preliminary rule

• Longitudinal with allergy history.
  80% of unique patients must have at least one coded entry, with “none” being an allowed entry (hospitals and practices).

Final rule

• Unchanged.

Demographics

Preliminary rule

• Practices: preferred language, insurance type, gender, race, ethnicity, and data of birth.
  Hospitals: all of the above plus date and cause of death if applicable.
  80% of patients must have demographics recorded as structured data.

Final rule

• Threshold dropped from 80% to 50% .

Vital Signs

Preliminary rule

• Height, weight, BP, BMI, growth charts for patients 2-20 years old, temperature, pulse.
  80% of patients aged 2 and over must have blood pressure and BMI entered.
  Children 2-20 must have a growth chart.

Final rule

• More than 50% of patients 2 years and older must have height, weight, and blood pressure recorded as structure data. EPs who believe that measuring and recording height, weight and blood pressure of their patients has no relevance to their scope of practice can be excluded. For MU purposes, providers do not have to maintain BMI and growth charts, although certified EMRs are required to do the BMI calculation and display growth charts with structured data.

Smoking Status

Preliminary rule

• Record if current smoker, former smoker, or never smoked.
  Must be recorded for 80% of patients.

Final rule

• Must record at least 50% of patients 13 and older for smoking status.

Clinical Decision Support Rule

Preliminary rule

• Included five measures beyond drug screening, based on demographics: diagnoses, lab results, or medication list. Real-time alerts and suggestions based on evidence. Track response to alerts.

Final Rule

• Implement one clinical decision support rule relevant to specialty or high clinical priority for EPs, or one clinical decision support rule related to a high priority hospital condition for hospitals. Also must track compliance with that rule.

Record Advanced Directives

• This is a new one not included in the preliminary rules to prove meaningful use. Hospitals must record at least 50% of inpatients 65 years old or older an indication of an advance directive status.

Structured lab results

Preliminary rule

• Display results, translate LOINC codes, allow maintenance based on new results.
  Must record as structured EHR data 50% of all results that are delivered in positive/negative or numeric format.

Final rule

• Threshold reduced to 40% of clinical lab test results.

Patient Lists

Preliminary rule

• Allow user to select, sort, retrieve, and output patient lists based on demographics, medications, and conditions.

Final rule

• Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.

Report Quality Measures to CMS and States

Preliminary rule

• Calculate, display, and submit quality measure results.

Final rule

• Clarification: this is for hospital quality measurements. For 2011, provide aggregate numerator, denominator, and exclusions through attestation. For 2012, measures must be electronically submitted.

Patient Reminders

Preliminary rule

• Practices only: issue based on patient preferences, demographics, conditions, and medication list.

Final rule

• Reminders must be sent to at least 50% of patients age 50 or over that are seen by the EP.

Insurance Eligibility

Preliminary rule

• Allow user to record and display based on eligibility response from insurer.
  Must cover 80% of unique patients.

Final rule

• Requirement withdrawn for Stage 1 but look for it in Stage 2.

Submit Claims

Preliminary rule

• Must submit 80% of all claims filed electronically.

Final rule

• Requirement withdrawn for Stage 1 but look for it in Stage 2.

Electronic Copy of Health Information to Patients

Preliminary rule

• Allow user to create an electronic copy of test results, problem list, medication list, medication allergy list, immunizations, and procedures. Hospitals must also provide a discharge summary, but not procedures. Must provide an electronic copy of health information to requesting patients within 48 hours.

Final rule

• Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies,
  discharge summary, procedures), upon request. Discharge summary and procedures are for hospitals only.  Must provide to at least 50% of requesting patients within three business days.

Electronic Copy of Discharge Instructions 

Preliminary rule

• Hospitals only.  Must provide electronically to 80% of discharged patients who request them.

Final rule

• Threshold reduced to 50%.

Timely Patient Access to Health Information

Preliminary rule

• Practices only: diagnostic results, problem list, medication list, medication allergy list, immunizations, and procedures. Within 96 hours of availability.
  Must provide to 10% of unique patients.

Final rule

• Practices must to 10% of its patients within four business days of being updated in the EHR, subject to the EP’s discretion to withhold certain information.

Clinical Summary of Each Office Visit

Preliminary rule

• Practices only: diagnostic results, medication list, procedures, problem list, immunizations. Must provide for 80% of office visits.

Final rule

• Provide clinical summaries provided to patients for more than 50% of all office visits within three business days.

Access to patient-specific education resources

• Another new item that was not in the preliminary rules. Use EHRs to identify patient-specific education resources and provide those resources to the patient if appropriate. Both EPs and hospitals must provide patient-specific education resources to at least 10% of patients.

Information Exchange

Preliminary rule

• Enable electronic sending and receiving of diagnostic test results, problem list, medication list, medication allergy list, immunizations, and procedures. Hospital requirements also include a discharge summary. Must conduct at least one test of information exchange.

Final rule

• Exchange key clinical information among providers of care and patient authorized entities electronically. Both practices and hospitals should exchange problem list, medication list, medication allergies, and diagnostic test results; hospitals should also exchange discharge summary and procedures.

Medication Reconciliation

Preliminary Rule

• Compare and merge two or more medication lists into a single list that can be displayed in real time. Must be performed in 80% of encounters and care transitions.

Final Rule:

• Threshold is reduced to 50%.

Submit Data to Immunization Registries

Preliminary rule

• Must conduct at least one test of submitting information.

Final rule

• Perform at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP, hospital, or CAH submits such information have the capacity to receive the information electronically).

Submit Lab Results to Public Health Agencies

Preliminary rule

• Hospitals only. Must conduct at least one test of submitting information.

Final rule

• Perform at least one test and follow up submission.

Submit Syndrome Surveillance Data to Public Health Agencies

Preliminary rule

• Must conduct at least one test of submitting information.

Final rule

• Perform at least one test and follow up submission.

Protect Electronic Patient Information

Preliminary rule

• Unique identifier, emergency access for authorized users, session timeout, encryption where preferred, encryption when exchanging information, maintain audit logs, provide integrity check for recipient of electronically transmitted information, verify user identities and access privileges, record PHI disclosures.
  Must conduct a security risk analysis and implement security updates.

Final rule

• Conduct or review a security risk analysis, implement security updates as necessary, and correct identified security deficiencies.

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Meaningful Use – final

Click the Fullscreen link at the top to read more easily.

We will be adding comments to this post as we find important facts in the long document. Feel free to add your own findings or thoughts.

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The views and opinions expressed in this blog are mine personally, and are not necessarily representative of Texas Health Resources or its subsidiaries.

Strategic Plans — Getting to 2.0

I recently met up with a friend I hadn’t seen in a decade. After breaking the ice, we shared deeper life stuff. As I tried to understand the aura of weariness and apathy hanging on my friend, I realized with sadness that he had no focus for his future. No vision.

He was going nowhere and getting there too quickly. Opportunities crossed his path, but he didn’t take them or he had taken notice of them too late. I dreaded to think how many regrets he’ll face on his deathbed.

As you know, this bankruptcy of success doesn’t just occur with individuals. I listened to a guest speaker ask a leadership team to cite the enterprise vision. The audience fell silent! A departmental vision? she said. More silence. Personal vision? Silence. The group was wandering, but you’d never guess that by reading their strategic plan. A plan written but not lived out is an epidemic tragedy.

In a 2007 post, I shared my thoughts on “Taking Control of your Destiny,” encouraging readers to have a carefully crafted plan for business and for life. The number of businesses and individuals who wander through time without connecting to their purpose is frightening.

Try this test to see if your organization has an effective plan. Ask staff members to cite from memory your mission and vision. Could they explain how strategies are aligned to clinical and business imperatives? Ask them to tell you the one thing that provides focus. A failure to pass this test reveals a failure of future success. It’s time to act.

Moving on …

For those who have past the above test and have a functioning plan in place, what’s the next level? As you would imagine, I’m a deliberate planner, forever exploring creative and innovative approaches. Here is one.

This spring, the IT leadership teams of Texas Health Resources and Pier1 met for an all-day strategic planning session. In the morning, my team and I presented the Texas Health strategy and dived into the IT components. In the afternoon, we reversed roles.

Together we rolled up our sleeves and challenged one another throughout the presentations. We shared experiences and best practices, offering unique perspectives as consumers and patients. We poked holes and pressed buttons and then commiserated. What we learned from one another added value not only to our corporations, but to each individual.

The big takeaway for us affected our approach to (clinical) business intelligence. Recognizing that we were headed in a direction sub-optimal to our potential, we heeded their experienced-based counsel and immediately changed direction to avoid significant future pain. In fact, Pier1 CIO Andrew “Andy” Laudato now serves on our business intelligence committee.

Another takeaway tactic I intend to employ: if Pier1finds an IT-related expense in the organization that’s not currently part of IT, they move it to the IT budget immediately. Even though this causes a negative budget variance, it allows the organization to understand the complete cost of IT and provides them control in the future. Simple, but profound.

This fall, we’ll have another exchange, this time with Radio Shack. I had lunch with their CIO Sharon Stufflebeme this week to hammer out details. Our teams are psyched. I’m hoping to celebrate a Le Tour victory when we visit their headquarters.

How do you make this happen? Look for innovative CIOs outside of healthcare. I serve on the Texas Christian University advisory board, and when I first joined, Andy (Pier1) presided over the board. Fascinated by his leadership and accomplishments, I made an appointment. While visiting in his office, it became clear to me that Pier1 would be a good match for my team.

At another time, I was speaking on a panel with Sharon from Radio Shack. Her leadership style differed from mine, and she was very successful. On the panel, we worked as contrarians, and I benefitted from that diversity. I have great expectations for the impact she and her team will have on our planning and thinking. We need people to rock our world, business and private. Iron sharpens iron.

You might be asking, Why doesn’t he have these exchanges with healthcare providers?

Good question. In specific areas, we tap into peer organizations on topics ranging from cost allocation methodologies to enterprise PMO. For example, we belong to excellent think tanks like Scottsdale Institute that enable exchange of ideas. Although these are helpful, they carry limited value, for if we restrict ourselves to healthcare peers only, IT will continue to lag. So we reach out beyond our protective covering to break free of the chains binding us to lack of foresight and preventing the fulfillment of our purpose.

Avoid the epidemic tragedy that plagues present day IT. Encourage your subordinate units to develop plans that support the organization so you have complete line of sight from top to bottom. As a bonus, encourage them to create personal plans. They’ll thank you for it. Remember: living without purpose is the greatest invisible tragedy that’s never perceived until the end. And then, it’s too late.

Update 7/16/10

Thank you for the feedback to my recent post on strategic plans — Getting to 2.0. I am pleased that some are finding the ideas and concepts helpful. One of the first questions I ask when I see a floundering person, division, or company is for a copy of their plan. I have never met a person or company with a well thought out plan who is floundering, but the inverse is true 100% of the time. Those who flounder have no plan.

I am sorry for Hamon Tower Patient experience. As articulated by HHS in the MU announcement, transforming healthcare delivery with technologies such as EHRs and RTLS is a journey and that we are continuously working with our caregivers to improve their experience and that of our patients. In the spirit of continuous improvement and openness to collaboration, we would welcome the opportunity to connect with you offline to learn more about your  experience. Please send me an e-mail directly and I will set something up.

Ed Marx is senior vice president and CIO at Texas Health Resources in Dallas-Fort Worth, TX. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook, and you can follow him via Twitter – User Name “marxists.”

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From Holy Smoke: “Re: Cerner. Misidentification incidents have been reported with Cerner PowerChart and Millenium in hospitals in Indiana, Michigan, and others after a Cerner upgrade. Entries are placed in the wrong electronic chart and reviewed data is for the wrong patient.” Unverified. I saw nothing in the FDA’s Maude database, so if it’s happening, customers should file an experience report.

Former Cerner COO Paul Black, now working with a private equity firm, is named board chair of Truman Medical Centers (MO).

Lots of us may benefit from the redistribution of taxpayer money into our healthcare IT pockets, but our taxpayer side apparently wins, as almost 2/3 of readers say they wouldn’t have voted for HITECH had they been given that chance. New (similar) poll to your right: if you’d had the chance to vote on Don Berwick’s nomination to CMS administrator, would you have voted for him?

Health officials in Canada’s Northwest Territories say they’ll start enforcing medical faxing policies requiring cover sheets and pre-programmed telephone numbers after patient information was faxed to the CBC in at least four separate incidents. A recent embarrassing incident had led to a temporary ban on medical faxing except in emergencies. This caused big problems for pharmacies, who were given no advance notice that the 30-40% of their business that involves faxing would be shut down.

Doctors in Taiwan are taking iPads to the bedside, using them to show patients their diagnostic images right in their beds.

Bruce Greenstein, a Seattle-based Microsoft managing director of worldwide health, will become secretary of Louisiana’s financially struggling Department of Health and Hospitals after incumbent Alan Levine quits to go back to the private sector. Levine was previously CEO of Broward Health (FL).

Senator Richard G. Lugar of Indiana pitches HIT during a stop at Union Hospital East and at the remarkably coincidentally named Richard G. Lugar Center for Rural Health, which does some small telemedicine projects. The article mentions some of the hospital’s technologies: smart beds, patient tracking systems, bar code scanning, electronic inventory, and and Vocera communicators.

Inga and I are thinking that we need to get our ears a little closer to the ground with all the healthcare IT news that’s breaking this summer (mergers, Meaningful Use, etc.) We’re thinking of anonymously crashing the Allscripts user group meeting in Las Vegas the first week of August since that’s a pretty big one that should give us lots of insight beyond just Allscripts news. Inga always does MGMA. I usually only go to HIMSS, but I’ve got a lot of time off at work and figure I might as well do something useful with it. We will report the rumors and trends from wherever we end up.

Struggling Grady Memorial Hospital (GA) is criticized for giving its CEO a $291K bonus on top of his $615K salary. The board says he put the hospital into the black and met his performance targets, but it’s still getting $80 million per year from taxpayers. And in Calgary, the CEO of Alberta Health Services earns $744K in 2009 while the organization failed to meet many of its goals and ran a $885 million deficit.

More on Don Berwick’s Institute for Healthcare Improvement. Tax records indicate that it took in $43 million last fiscal year, of which Berwick was paid almost $2.5 million, although $1.4 million of that looks like vested benefits from the previous seven years and his base salary plus bonuses was $621K. Nothing unusual or extravagant that I can see.

As a comparison, HIMSS reported $41.4 million in revenue, about the same as IHI, according to its most recent tax documents filed in May. Only $5.3 million of that came from member dues, while the annual conference raked in $18.9 million. Steve Lieber received compensation of $731K (CEO). Other salaries are above: Dave Garets (former CEO of HIMSS Analytics), Carla Smith (EVP), Norris Orms (EVP/COO), Jeff Kenjar (EVP Sales, HIMSS Analytics), Mike Davis (former EVP, HIMSS Analytics), Kelly Laidler (senior director, sales), and Jessica Daley (sales director, HIMSS Analytics). The Advisory Board must be paying Garets and Davis really well since they walked away from some pretty big salaries. HIMSS isn’t big on technology, apparently, having spent $675K on IT, a paltry 1.6% of expenses.

Former Columbia HCA president and Florida gubernatorial candidate Rick Scott challenges the state’s “millionaire” campaign finance law, saying it restricts his free speech by giving his opponent matching state funds once Scott spends $24.9 million. Scott has spent $20 million so far. His opponent’s campaign manager said, “It should come as no surprise to anyone that Rick Scott, a man who oversaw the most massive Medicare fraud scheme in history, just can’t seem to play by the rules.”

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From Sturges: “Re: The Berwick saga is a great view into just how political healthcare is right now (and will be through 2012). It obviously will be a big topic in November, a key part of the Berwick opposition in the first place. It also will command big attention next year as Congress takes on the deficit. The upshot is cuts for hospitals on the spending side in ’11 and a much more political environment for the rule-making process on the regulatory side in ’11-13. Mr HIStalk for Congress? Your slogan can be, ‘I think it’s crap, too’ or, if we need something more positive, ‘Yes we can — anonymously!’” Don Berwick was the right person for the job, I’m convinced (though why he’d want it is beyond me) and even though people don’t want to hear it, some kind of financial allocation (“rationing”) is unavoidable given the way the current and previous administrations have put the country deeply into debt to preserve the illusion of prosperity. It’s political poison to cut healthcare and entitlements, but Berwick is right — we don’t have a choice, especially now that the government controls so much of healthcare delivery and payment.

Speaking of Don Berwick, this article says he makes almost $900K running IHI and listed more than a dozen current jobs on his ethics filings, but most of them are voluntary or honorary, including compensation-free positions at Children’s Boston, Harvard, and Brigham and Women’s that the White House describes as “essentially honorary professorships.” The article suggests that the White House inflated his credentials with those positions, but I don’t see it that way — it looks like they just wanted to include everything whether they were required to or not. It does mention, however, that in taking the CMS job, Berwick’s annual salary will drop to $165K for running a $800 billion organization. That sounds like public service to me.

From TooLate: “Re: iSoft. To make cuts to UK staff — sales and marketing, product strategy, and implementations.” The company looks to be an acquisition target, which means slashing expenses to make short-term numbers attractive. It announces a $30 million credit facility from an obscure US investment fund, which the company will use to replenish the cash it spent on 2010 acquisitions (which didn’t help much given that shares are still at or under 20 cents).

From Lemmy: “Re: E&Y. From this job posting, it does appear that your rumor that they are trying to rebuild their healthcare consulting business is correct.”

From HITInsider: “Re: Eclipsys. It joins Epic as the only vendors with CCHIT Certified 2011 Enterprise certification.”  

From Wildcat Well: “Re: Tim, ol’ boy. ARRA, HITECH, and now $1B for broadband initiatives including health centers. Comcast. Microsoft. All talking. Time for the adults to take over. Most EMR vendors could be an afterthought. Buy stock.” I keep getting rumor reports about EMR executives talking shop with the cable operators, but I don’t have details. Not that I wouldn’t enjoy having some, mind you.

From Frank Poggio: “Re: A Meaningful Ruse. As a follow up to by February Readers Write piece, note today’s announcement: The Centers for Medicare & Medicaid Services has issued a proposed rule imposing a 0.25 percentage point reduction to the fee schedule increase factor for outpatient hospital services. If you do not met meaningful use criteria, which most providers won’t per the recent Glaser interview, you get a reduction in this adjustment. Let’s see, that’ll be 0.33 times -0.0025 = +0.000825 increase! Or is it 0.66 times -0.0025 = -0.000166 decrease? Seems to me either way you come out better.”

From HCDude: “Re: KLAS report on professional services firms. New players are entering the market. It doesn’t look like all the acquisitions done by IBM, CSC, and ACS worked. One of these days, the big boys will realize this is a cottage business where big companies just don’t ever seem to get it.” KLAS says all those acquisitions drove the principals to leave and start new companies, bringing people with them. They specifically mentioned Encore and Santa Rosa, started by former executives from Healthlink and Superior, respectively, saying that while Encore didn’t make its list because it wasn’t consider by prospects often enough, it still earned as much attention as CTG. This life cyle is obvious to old timers who have seen it time and again:

1. Sales-savvy former consulting company executives start their own consulting company.
2. They cherry-pick the good consultants who want a change, offering clients the same people and services at half the price the big boys charge since they have low overhead and no shareholders.
3. They build up the business, finding some niche for which providers are willing to pay.
4. They dress up the offerings by claiming to be in “life sciences” (i.e., make it sound like rich drug companies and foreign genomics rock stars are beating their doors down).
5. They wait for some industry development that makes consulting look like a hot industry that will never fade (data warehousing, CPOE, Meaningful Use, ERP, etc.)
6. They sell out to a cash-rich, often plodding big company that’s tired of low-margin hardware sales which thinks consulting looks easy and profitable and which is too lazy and impatient to start their own consulting organization, preferring instead to pay a ridiculous premium for a company that basically does little beyond reselling the bodies it employs at multiples of what it pays them.
7. The former consulting company executives, flush with cash and quickly fatigued by corporate BS, leave the stifling bureaucracy claiming they will retire or pursue non-competitive interests.
8. Go to #1.

From The PACS Designer: “Re: Scribus. TPD has been testing open source desktop publishing software called Scribus. It’s kind of like Visio, which has been around for a long time, but has more robust features.”

Listening: The Smiths, influential early 80s Brit indie pop featuring Morrissey on vocals. Still sounds good.

McKenzie Medical Imaging (OR) wins NueSoft’s Make Software Sexy video and photo contest, featuring user submissions with employees wearing free company tee shirts. I may steal that idea.

Proposed HITECH-related HHS modifications to HIPAA (warning: PDF) would expand the right of patients to access their own information, restrict some types of disclosure, and expand rules to cover business associates. AHIMA releases a statement supporting the change (one paragraph) and pitching itself and its members as being essential to further discussions (three paragraphs). We asked privacy advocate Deborah Peel, MD of Patient Privacy Rights for her reaction:

What we heard in the remarks of Secretary Sebelius, OCR Director Verdugo, and the National Coordinator for HIT Dr. Blumenthal is a very significant and welcome major change of direction at HHS and ONC. Several VERY strong, positive comments were made today in the press conference announcing the NPRM today by Sec. Sebelius, OCR Director Verdugo, and Dr. Blumenthal which support the patient’s right to privacy and consent. Sec. Sebelius said. “It’s important to understand this announcement [of NPRM, a new Web site, and other new initiatives] are part of an Administration-wide commitment to make sure no one has access to your personal information unless you want them to.” Then during her remarks, OCR Director Verdugo said, “The benefits of health IT will only be fully realized if health information is kept private and secure at all times.” And finally during his comments, Dr. Blumenthal stated, “We want to make sure it is possible for patients to have maximal control over PHI.” And he referred to the Consumer Choices Technology Hearing last week, which demonstrated consent tools enabling patients to make choices about how their information is used and disclosed from EHRs and for HIE.

The great news from the press conference announcing the NPRM was the very CLEAR language, from the Secretary of HHS, to the Director of OCR, to the National Coordinator for HIT, that supports building Americans’ rights to consent and control over PHI into electronic health systems and data exchange. We hope the details in the NPRM actually do give Americans the kind of control over sensitive personal health information that will enable them to trust health IT systems and data exchanges. We will share our analysis of/comments on the NPRM as soon as we have it.

Royal Philips Electronics announces that President and CEO Gerard Kleisterlee will step down in April, announcing that it will nominate former Philips board member Frans van Houten to replace him.

HealthcareMegaMall is running a text ad here announcing a September 1 go-live, but I know nothing about the company. A Google search finds this press release, which describes it as an online marketplace for sharing information, comparing products, and viewing demos (including HIT products, apparently). They’ll also communicate with providers and advertise both in print and electronically (so I guess that explains the ad).

On HIStalk Mobile, we review ReachMD, which offers medical CME via the iPhone.

Jobs: Cerner SurgiNet and PowerOrders PMs, Manager, Clinical Informatics, Senior Software Engineer, Cerner Clinical Analyst.

Weird News Andy finds this story of an enterprising London hospital that “generated substantial income” by renting out an empty patient unit to a film company that used it as a location in a big-budget porn movie.

Gwinnett Hospital System (GA) expects to save $300K per year and speed up its revenue cycle as a result of its medical records digitization project involving EDCO Group’s Solarity technology.

Baltimore’s mayor will announce as the city’s new health commissioner Dr. Oxiris Barbot, a pediatrician whose credentials include creating an EMR for New York City’s school health system and developing disease management and public health programs. The search committee was led by Michael Klag, MD, MPH, dean of the Baltimore-based Johns Hopkins Bloomberg School of Public Health and a member of HHS’s HIT Policy Committee.

Two Australian hospitals will implement an ICU EMR system from Vision Software Solutions of Queensland. I can’t say for sure, but I’m guessing it’s actually the iMDsoft MetaVision system since Vision is (or was at one time, anyway) a distributor for it in Australia.

I don’t recall if I already knew this, but apparently Resurrection Health System (IL) is going Epic, based on this job listing.

Cal eConnect, the group created to oversee California’s HIE projects and to spend $39 million in federal money, hires Carladenise Edwards as CEO. She was formerly HIT coordinator for the state of Georgia, an HIT advisor to former Florida Governor Jeb Bush, executive director of South Florida Health Information Initiative, and owner of a consulting company that sold services to Florida’s state government.

Strange: hospitals in China, reacting to a rash of patient deaths due to suspected medical negligence, hire local police officers to “improve relations” between doctors and patients. Critics say hospitals are cozying up to police to get them to arrest people who complain about their medical services. State-run media coined the phrase “hospital troublemaker” to describe unhappy family members who display banners, set up altars, or abandon the corpses of their deceased family members, any of which could get them locked up.

E-mail me.

HERtalk by Inga

The 120-provider Physicians Alliance (PA) plans to implement Allscripts EHR, which will connect directly to its existing Allscripts Vision PM system. Allscripts execs, by the way, are meeting with bankers to secure up to $720 million to finance the buyout of Misys Plc’s ownership stake and the purchase of Eclipsys.

Physicians running Advanced Data Systems PM/EHR will soon be able to connect to the Jersey Health Connect HIE using RelayHealth’s HIE tools.

Ochsner Health System (LA) says it is now connecting thousands of community physicians to Ochsner’s patient medical records using Orion Health’s HIE technology.

Speaking of HIEs, KLAS says only five vendors are considered in more than 10% of purchasing decisions: Medicity, Axolotl, RelayHealth, ICA, and Epic (the latter in Epic-to-Epic exchanges). Cerner, dbMotion, GE, InterSystems, and Orion rounded out the top 10.

The Santa Cruz HIE implements Anakam Identity Suite into its Axolotl Elysium Exchange to provide secure access to health information.

Dr. Bill Tierney is named CEO of the Regenstrief Institute, taking over for Dr. Tom Inui on October 1.

Christ Hospital (NJ) selects Allscripts reseller ITelagen to provide EHR and PM for the hospital’s affiliated medical practice.

Health Net agrees to pay $250,000 to the state of Connecticut to settle a HIPAA violation case. The suit stems from the theft of a disk drive that contained financial and medical data on 1.5 million consumers, 500,000 of them from Connecticut. The deal also includes two years of credit monitoring, $1 million of identity theft insurance, and reimbursement for the costs of security freezes.

Industry veteran Mark Trigsted is named EVP of healthcare for Diversinet. Trigsted must have friends all over HIT, having worked previously at 1-800-Doctors, Sysware, HEALTHvision, Sunquest, Oacis, McKesson, and GE Medical.

EDI testing service QualEDIx names Larry Watkins EVP of healthcare strategy and business development.

Six orthopedic surgeons from Rush University Medical Center (IL) are under fire for violating Medicare rules. The US District Court says the physicians routinely overbooked their schedules and relied on residents to perform surgeries. A fellow surgeon and a former hospital executive filed the suit.

E-mail messaging between patients and providers improves the quality of care provided, according to a Kaiser Permanente study. Patients with diabetes and/or hypertension were found to have statistically significant improvements in HEDIS scores when patients and physicians communicated via e-mail and were 7-10% less likely to schedule an office visit.

Elsevier launches Top Doc, an iPhone app designed to help medical students and residents improve with visual diagnosis skills. The $15 app includes quizzes with more than 600 questions and allows user to determine the correct diagnosis by viewing actual photographs. You can even have your grade posted to Facebook. Kind of cool, but I’ll stick with Scrabble.

E-mail Inga.

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