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Epilogue to the story of the whistleblowing nurses

For a while now we’ve been following the story of Anne Mitchell, RN and Vicki Galle, RN who reported a physician to the Texas Medical Board. It seemed that the final chapter was written in February when Mitchell received a not guilty verdict from the jury. Galle’s case had been dropped earlier.

However, the latest detail of the case emerged this week with the announcement that the nurses will share a $750,000 payment from Winkler County, TX where the original charges were filed.

Click here to read more about the update.

The quality of internationally trained practitioners

It may be a struggle for credentialing professionals to track down a candidate’s information from an international medical school, but those struggles aren’t in vain , according to a new study about internationally trained practitioners. In fact, they may be some of the safest practitioners on a medical staff.

The study, “Evaluating The Quality Of Care Provided By Graduates Of International Medical Schools,” was recently published in Health Affairs. Here’s a snap shot of some of the findings:

  • Patients of foreign-born, international medical graduates had a death rate of 5%
  • Patients of American-born, international medical graduates had a death rate of 5.8%
  • Patients of American born and educated medical graduated doctors had a death rate of 5.5%

AHA asks CMS to expand telemedicine requirements

It’s great that the Centers for Medicare & Medicaid Services (CMS) expanded its telemedicine requirements, but they haven’t gone far enough, says the American Hospital Association (AHA).

Last week, AHA sent CMS a letter commending proposed changes which would allow hospitals to credential and privilege by proxy those telemedicine providers from hospitals in compliance with CMS’s Conditions of Participation (CoP). However, the AHA points out that CMS should go a step further and allow hospitals to privilege by proxy providers coming from organizations other than hospitals as long as the other organization, such as a radiology group, complies with the Medicare Conditions of Coverage.

AHA states that these proposed changes will benefit all hospitals, especially rural organizations which are frequent users of telemedicine services, but often lack the resources to adequately credential and privilege these providers on their own.

Nursing board says midwives should tell patients if they don’t hold hospital privileges

Should midwives who assist patients with at home births tell their patients whether or not they have hospital privileges? Yes, says the Iowa Board of Nursing.

Carey Ann Ryan, a nurse-midwife working in Iowa, recently agreed to pay a $1,000 fine to the state and enroll in an ethics education program in part because she did not tell a high risk patient that she did not have hospital admitting privileges, according to a July 22 article on

The patient in question eventually switched healthcare providers before her delivery and delivered in a hospital four weeks before her due date.

The case raises interesting questions about what information practitioners—hospital based or otherwise—should disclose to their patients.

Other issues that practitioners disclose to their patients may include if they accept Medicaid payments and if they have ties to pharmaceutical companies.

What information do your medical staff members disclose to patients? Share your experiences in the comment boxes below.

CMS updates quality reporting programs

If your quality reporting program does double duty by collecting data for OPPE as well as the Centers for Medicare and Medicaid Services’ (CMS) Physician Quality Reporting Initiative (PQRI), it may be time to take a closer look at the PQRI.

As our sister site, Health Leaders Media, explains physicians who report quality measures to PQRI using electronic health records (EHRs) will soon be able to combine data with physicians who demonstrate “meaningful use” of those records under the HITECH Act. Under the new healthcare reform law, the deadline for combining the two programs is Jan. 1, 2012.

Check out “Accomplish buy-in through linking financial incentives to quality measures,” (Briefings on Credentialing, February 2009) for more information about quality reporting programs.

Technology news: CT scan risks outlined in NEJM article

It may be time for your technology assessment committee to revisit the risks and benefits of CT scans. These popular scans were the focus of a recent New England Journal of Medicine article that warned of long-term cancer risks and potential radiation overdoses, according to a June 23 Los Angeles Times article.

Some say practitioners use the scans too often because they are pressured by patients to order them, or because fear of malpractice lawsuits leads to over testing.

However, one of the biggest risks to patients is that the radiation dose in CT equipment can vary widely from hospital to hospital.

Does your technology assessment committee evaluate existing technologies or only proposed technology changes? Share your experiences in the comment boxes below.

Doctors cheat on ABIM certification exam

The American Board of Internal Medicine (ABIM) claims that about 140 practitioners cheated on certification exams, according to a June 9 Wall Street Journal article. ( The practitioners allegedly purchased test questions from a test-prep company, which violates the ABIM’s test policy signed by test takers.

However, Christine Cassel, M.D., president and chief executive of the ABIM, is quick to point out that most test takers are honest and take the certification exam in good faith.

Click here to learn more about the case, and read “ABIM Sanctions Physicians for Ethical Violations,” on the ABIM’s website. (

More analysis about The Joint Commission, CMS, and telemedicine

Log onto our sister site,, for the latest information about the ever changing telemedicine standards.

“Joint Commission Pushes Back Telemedicine Requirements Until March 2011.”

Q & A: Medversant speaks about its role in Washington’s credentialing database

The credentialing conversation is moving in a new direction in Washington State where Senate Bill 5346 (SB 5346) is building the foundation for a state-wide credentialing database. Briefings on Credentialing profiled the bill in the July issue (available online at

Medversant Technologies, LLC is the company developing the credentialing database. Matt Haddad, president and CEO of Medversant explains more about his company’s role:

Q: Why did you decide to become involved in the implementation of SB 5346?

A: We became aware of the RFP in 2009 and determined we had the technologies and capabilities to meet the state’s needs.

Q: How would you describe your current state of progress in developing the state wide credentialing database?

A: The compliance date [is the] end of 2010, we expect to be live with the collection database and interface shortly.

Q: What are some of the most helpful comments you’ve received from hospitals and medical staff services professionals who will use the database?

A: There were many comments expressing the need for accurate verified data as well as data that is truly interoperable with legacy systems. I believe we have created exactly what the market has demanded.

Q: When do you think the database will be up and running? What’s your time frame?

A: We are finished with development and most of the customization requirements and should be ready to deploy shortly. Deployment is being coordinated with different state related organizations and public awareness campaigns. We have not been given an exact date for launch as of yet.

CMS updates telemedicine guidelines

Hospitals and critical access hospitals (CAH) will soon be able to use credentialing and privileging information about telemedicine providers from the remote location, according to proposed Centers for Medicare & Medicaid Services (CMS) changes to the Conditions of Participations (CoP). The proposed rule will be published in the Federal Register for public comment on May 26.

Previously, CMS allowed hospitals and CAH to accept credentialing information about telemedicine providers from the distant site, but not privileging information.