A recent article, Anatomy of a Tragedy has me thinking a lot about the importance of credentialing. It’s the story of a young neurosurgeon whose license has now been revoked after several patient deaths, and the paralysis of others. While this is a horrific, extreme case, it serves as a good reminder about the critical role Medical Staff Services play in obtaining required information to ensure a provider’s qualifications.
Why Peer References Matter
Healthcare credentialing is the systematic approach to the collection and verification of a provider’s professional qualifications. These qualifications include relevant education, training, licensure, and certification to practice in a healthcare field. There is an assessment of whether the provider meets certain criteria relating to professional competence and conduct. And lastly, there is the peer evaluation element.
Along with being a vital element of the credentialing process, obtaining peer references is the most labor-intensive and time-consuming step.
Consider the typical peer reference scenario: a busy physician with an office practice also sees patients in one or more hospitals and does procedures in an ambulatory surgery center. She receives by mail, fax, or e-mail a request from a hospital medical staff office or a managed care credentialing office to complete a peer reference questionnaire on an applicant. She may also be receiving requests about this applicant from other hospitals and healthcare entities to which the practitioner is applying. If the peer knows the applicant well and has been personally contacted by that applicant, she may take 10 minutes and fill out the questionnaire as soon as she receives it. If the request came by e-mail, she or her office staff will first need to print the questionnaire so she can fill it out. In all of these scenarios, even if the doctor has taken the step to complete the form upon receipt, getting the information back to the credentialing specialist is also dependent on that very busy doctor and her staff.
More commonly, reference requests sit on the peer reference’s desk, fax machine, or e-mail inbox, and will require a second request (which just adds to the stack of reference requests the peer receives) or a follow-up phone call from the credentialing professional.
The credentialing specialist repeats this process for each of the peers for each applicant. And the credentialing specialist is not just working on one application; there is a never-ending influx of time-sensitive applications, with 30-50 applications typically in process at any given time.
There is a better way
SkillSurvey Credential OnDemandTM is an online, paperless peer referencing solution that speeds up the credentialing process for medical staff services teams and physicians. The credentialing specialist enters the peer reference information electronically. A link for completion of an online competency evaluation, along with the applicant’s Request for Privileges and Authorization for Release of Information, is then automatically and immediately e-mailed to all peers. The peer reference completes the evaluation tool online, as opposed to having to print and then manually fill out a hard copy form. As soon as the evaluation is completed and electronically signed online, it is immediately accessible by the credentialing specialist at the healthcare organization. Total turnaround time is typically less than five days beating the current industry standard of 4-5 weeks.
Providing a more “user friendly” method for peer references to respond makes it more likely that the peer reference will respond … and in a more timely manner. And, it means that credentialing teams can easily access responses as soon as they are completed by the peer reference.
As the original article shows, having quick, verifiable and up to date references on healthcare practitioners can be the difference between life and death. The ability for the credentialing team to obtain peer reference responses in a timely manner without lowering your organization’s high standards for scrutiny of potential caregivers, can now be facilitated through technology in record time.
Linda Van Winkle is Director of Product Management at SkillSurvey. Prior to SkillSurvey Linda was Manager of Medical Staff Services at CHRISTUS St. Patrick Hospital in Lake Charles, Louisiana. Ms. Van Winkle developed a credentials verification organization, CHRISTUS Credentials Plus that achieved CVO certification status by the NCQA. She achieved CPMSM and CPCS certification and is a member of the National Association of Medical Staff Services.