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Cut the Cost of Credentialing While Improving Quality

February 22, 2018

Credentialing is a critical step to ensure that only quality practitioners are allowed to treat patients in your institution.

On average, for every 1,000 healthcare workers, there are 3 currently excluded individuals,7 historically excluded individuals, 2 sex offenders, 2 patient abusers, 20 practioners with inactive licenses, 3 on probation, 2 restricted or impaired, 1 revoked, and 10 suspended.

This is not speculation, it is what is found in the data. You are likely to find similar results in your population, but this, of course, assumes you are looking deeply enough at your population. It is not the number of issues you find that matters. It is the expense of the few you do not find. The implications of the few defines the importance of diligently understanding your entire population of caregivers.

What do you really know about your population of caregivers?

Most organizations are doing what they can with the resources available and consider that as “good enough.” Complete credentialing cannot be solved with people alone. Like most challenges in healthcare, a combination of people and technology is what is required to manage complex tasks. Without the right technology, the best teams can only scratch the surface of the vast amount of data sources required to understand the full background of an individual.

Challenges are compounded by organizational structure. Generally, work is done in many silos with no coordination between stakeholders. For example, what gets done in Human Resources is seldom handed off to a Medical Staff Services Office. The standard for “best practice” is having a complete understanding of your population stored in a single database with reporting for audits, uniform credentialing structure, and seamless integration of all data.

The fact is, to do comprehensive searches on an entire population of caregivers is daunting and labor intensive, but there is another way. Technology has enabled some companies to access thousands of primary sources and verify data from those primary sources without using hundreds of human resources to accomplish the task. These companies have harnessed Big Data with advanced robotic data acquisition in conjunction with expert analysts.

It would be difficult to build this on your own. You need to partner with a company that has solved the problem of advanced data acquisition and analysis. If done right, that company can deliver a superior service and reduce cost to operate a credentialing organization. But you also need a company that will stand behind their results to responsibly manage your risk.

The benefits of such an approach is cost savings with better quality. A single system that manages credentialing, enrollment, and committee approvals with a service organization that takes on many of the manual tasks related to credentialing. This does not require centralizing all the many functional areas of your business associated with credentialing, it does require consolidating the data and having a uniform approach to comprehensive credentialing.

Verisys Corporation is a full-service Credentials Verification Organization (CVO) with technology solutions and services that enable healthcare organizations to leverage our technology and services to save money and improve patient care. We would be glad to tell you how we are solving these challenges for our customers today.

#HIMSS18 #credentialing #bestinclassdata #protectpatients #verisyscorporation

About Joe Montler

Joe Montler

Joe Montler is Senior Vice President of Sales for Verisys. Mr. Montler is charged with leading Verisys’ sales by expanding Verisys’ best-in-class solutions in key market segments. Mr. Montler has 25 years of experience in health care technology and a deep understanding of the health care landscape that aligns perfectly with Verisys’ 25 years of health care market-specific leadership and experience.

As a former member of the McKesson Pharmacy Systems and Automation Leadership team Mr. Montler led Sales, Marketing, Strategy, Data Business Development as well as Data Sales. While at McKesson, he launched the flagship pharmacy management system growing its customer base from one to more than 3,000 sites. He tripled data sales, and guided the successful implementation of strategy for McKesson Pharmacy Systems and Automation division.

Mr. Montler has a BA in Communications and an MEd from Penn State University. Prior to McKesson, he worked at Misys, Delta Health and Shared Medical Systems.