Remember the 80’s? Wow, we’ve come a long way since then - from fashion, sure, but also in the healthcare industry. Take a stroll down memory lane with me as I discuss how much change the concepts of credentialing and privileging have seen in the past 30 years, and what we can expect in the next 30.
In a recent webcast, symplr spoke to expert Cris Mobley, who shared her experience as a NAMSS (The National Association Medical Staff Services) instructor, a former NAMSS president, and now president of her own consulting firm (C Mobley & Associates LLC). She talked about the history of the profession and how it led to the world as we know it today, and gave great advice for how to stay current as an MSP (Medical Staff Professional) in an increasingly complex world of compliance, systems, and regulations.
I’ve organize Cris’s conversation into a two-part blog series covering her main points. Let’s begin with a look back at the origins of credentialing and privileging…
“Back in the day”
Cris told us that she first started out as an MSP in the mid 70s. If you were also an MSP during that time, you probably remember – there were no reappointments, no privileging requirements, and no requirement for primary source verification.
In the 70s, there were primarily single community hospitals with no outpatient care or urgent care facilities, and ambulatory surgical units were not around.
Physicians were primarily in solo practices without a PA (Physician Assistant) or NP (Nurse Practitioner). And there was certainly no managed care, there was no FPPE (Focused Professional Practice Evaluation), OPPE (Ongoing Professional Practice Evaluation), or Core Measures.
And more to the point, there was no expedited credentialing and few, if any, temporary privileges. Providers simply had to wait a couple of months for application processing. There certainly wasn’t any credentialing or quality software. Nobody even had the internet!
You get the picture.
Yes, it really used to be that easy…
The primary role of a Medical Staff Professional was historically to manually process applications. Cut and dry. When it first came time for physician reappointment at the end of two years, the “no news is good news” policy worked for everybody. There just weren’t any “report cards” like we have today. And on the rare occasion an audit actually occurred, it was more to discipline physicians who weren’t doing a good job, rather than to focus on quality.
And then, we got the Internet…
(Cue ominous music). The early 2000s really is when things started to change significantly. Healthcare systems arrived. And with this arrival, we witnessed the emergence of group practices, exclusive contracts, employed physicians, and even “ancillary” specialists with exclusive contracts at hospitals (such as radiology and pathology).
As all of these new and more permanent faces started to show up in our healthcare facilities, the question of credentialing and privileging became a focal point.
In addition, CVOs or credentialing verification organizations were expanding from the early medical society services. There were about 80 medical societies around the country who, in the late 70s and into the early 90s, were actually processing applications for local hospitals. The concept of those early medical societies has evolved into today’s CVOs.
Some offices were just starting to use credentialing software, but many still were not. In addition, Peer Review became more of an advanced concept for use at reappointment time. Because of this advance, cases of negligent credentialing were on the rise. At the same time, NAMSS started offering a new credentialing certification called CPCS (Certified Provider Credentialing Specialist).
The Future is Now, Right?
So, fast forward 15+ years to the present, and think about how far healthcare has come! More than likely, you’re using credentialing technology now. As someone who works with a lot of hospitals, I see a varying degree of how people are utilizing their technology – some maximize it by continuing to learn and upgrade. Others have good systems but don’t take the time to really educate their staff. Still others have software but they kind of have this back-up manual system that they continue to use as a sort of “fail safe.” Honestly, it defeats the purpose of having software that will do the work for you, and it doubles your workload.
Good software allows you to complete the entire lifecycle of provider management. Applicants can strictly use the computer to fill out their application and privilege forms. And when your office is using this type of system, you can transition to paperless files (ie: paperless minutes, document storage, bylaws, policies and procedures). Our world is electronic, and very few of us have space for all of these paper files. Why mess with file cabinets when you can use virtual space?
Beyond just “going paperless,” think about it in terms of manpower. Since there are now software modules for everything from tracking privileging, to FPPE and OPPE, to quality metrics and performance improvement, your office can, and should, run much more efficiently. Even affiliations can be automated! You don’t have to respond to all the requests you get to verify your physician’s affiliations – this can all be done automatically via the internet and you can get a report of who’s queried, but it’s not time spent by you or your staff. Even if you don’t have a paperless electronic application, once you get the hard copy, you can (and should) scan that information to create your electronic file. In a different way, life has become really easy again!
I’m amazed by organizations who are still so resistant to using “new” technology (let’s be honest, the technology has been around for over a decade!). Embracing the times we live in means more efficiency, less manpower, and easier tracking and monitoring. And on top of that, you have vendors (like symplr with our Provider Management suite of solutions!) to help you every step of the way.
Coming Up Next
The second part of this blog series will cover expert advice for being a “rockstar MSP” in today’s fast-paced, complex world of compliance, regulations, and technology.
For more information about the past, present, and future of the Medical Staff Profession, listen to our symplr education series webcast with Cris Mobley. To learn more about simple and effective technology for credentialing, privileging, and peer review, schedule a demo with symplr now!