Maintaining current and accurate hospital privileging data is incredibly important for any healthcare provider organization. Doing so is at the heart of patient safety. It ensures that the providers your organization employs or contracts with are not only qualified, but will provide the highest quality care in the most efficient manner. In that way, privileging affects more than safety, extending to outcomes measures.
Don't jeopardize safety, quality, or outcomes
Accurate privileging reduces overall risk for healthcare organizations specifically by ensuring that the right physicians are working within the most appropriate clinical placement, toward predefined metrics that matter.
This is especially important in the era of value-based care and healthcare reform. In a world that rewards quality over quantity, organizations need another layer of integration and insight for provider data management, including the ability to map codes (e.g., ICD, CPT, HCPCS) to privileges and outcomes.
Such requirements are only the tip of the iceberg when it comes to privileging. That’s why using privileging technology is a smart solution for such a complex process that’s intertwined with quality improvement. Comprehensive privileging technology allows organizations to establish and maintain rigorous processes and extensive documentation easily and effectively, without missing any important steps or allowing data to slip through the cracks.
Bypass labor-intensive privileging processes
Hospitals have a tremendous responsibility to deliver high-quality patient care. But the only way they can do that is by working with qualified physicians who are properly privileged. The responsibility becomes even more complex for hospital systems since, often, privileges don’t apply to or carry over from other facilities within the system. This gap makes a confusing and extensive task even more overwhelming and complex for staff and providers alike.
Managing clinical privilege delineation is labor-intensive and requires an approach that's secure, thorough, and totally error free. In addition, the information that healthcare organizations need to gather and track is constantly changing. The documentation they collected last month might be outdated today. Circumstances can change on a dime and with little notice, creating liability for healthcare organizations whose processes and tools aren’t robust enough to keep up.
That's why using outdated methodologies—whether it's older software or, worse, paper-based methods—are unacceptable. Healthcare organizations require tools that cover the entire privileging lifecycle. Privileging doesn’t stop when the initial documentation has been obtained or vetted. The processes of privileging and reappointment are cyclical and ongoing, and the technology needs to be able to keep pace.
For instance, the Advanced Privileging tool from symplr covers the entire privileging lifecycle, including:
- Accessing the privilege forms library
- Generating privilege request forms
- Allowing practitioners to submit online requests
- Enabling recommendation and committee review by visual means
- Delineating privileges that accommodate provider requests for core privileges and their prerogative to opt out of any privilege
- Monitoring and evaluating performance to ensure continued quality and optimal outcomes
In addition, such tools should fully integrate with your existing systems for ease of use and to ensure a smooth workflow. Advanced Privileging from symplr fully integrates with other symplr provider modules, including the Application Manager, Committee Manager, Provider Profile, and Provider Lookup tools. There's also an optional integration with symplr Quality Review.
Benefit from a privileging software solution
Adopting a comprehensive and robust privileging software technology solution comes with many benefits that will allow healthcare organizations to build a foundation for a smooth and accurate privileging process. It also ensures that hospitals are using updated, best practices when privileging providers. Every step is done in real time and is automated to ensure that the privileges presented adhere to the most current standards and documentation possible.
A few must-have features for privileging software technology include:
- The ability to create and maintain privilege request forms
- The inclusion of a complete privilege forms library populated with easily-adaptable templates
- Forms with continuously updated data from established industry expert sources
- Corporate privileging capability
For instance, healthcare providers can use symplr's Advanced Privileging solution to create and maintain privilege request forms to stay compliant with current industry standards and regulations.
It allows users to:
- Create and maintain privileges via access to the symplr Provider Privileging library, which includes competency criteria outside of standard Accreditation Council for Graduate Medical Education and American Osteopathic Association curriculum-based training
- Review, customize, and edit privileges by specialty
- Place privilege request forms in draft format and publish them once they're approved
- Add or update core and special privilege definitions or create new practice areas
- Include text, such as page headers and signature lines, on privilege request forms
- Include education requirements for a practice area or privilege
Healthcare organizations further avoid potential risks, such as negligent credentialing, by using a comprehensive software solution that incorporates a full privilege library that's researched extensively by experts. As new medical procedures or devices are introduced, these expert researchers work directly with necessary sources to update the software tool with the minimum standards recommended for providers to possess these privileges.
As new medical procedures and technologies are introduced almost daily, it's smart to allow experts to handle the research for you. Doing so will enables your medical staff services office to focus on supporting the departments in adopting and delineating these privileges.
symplr's Advanced Privileging solution uses industry experts that tap approximately 40 resources when researching content for privileges in any specialty or subspecialty—for physicians, nurses, and other privileged providers. Those resources include important organizations like:
- American College of Graduate Medical Education/American Osteopathic Association
- The Royal College of Physicians and Surgeons of Canada
- American Nurses Association
- American Board of Medical Specialties
- American College of Cardiology
- Society of American Gastrointestinal and Endoscopic Surgeons
In addition, healthcare organizations should choose a solution that includes a corporate privileging functionality, because the same privileges aren’t always available at individual hospitals within the same system. A corporate privileging functionality allows multi-entity health systems to manage how each specific entity—acute, ambulatory, or other—to view, modify, and share practice areas and privilege setup records.
Corporate privileging also allows users to specify all or a subset of privileges to apply across the entire organization or by individual facility or entity, as mandated by regulators and accreditors (e.g., The Joint Commission). Finally, enterprise-scale privilege publishing enables rapid rollout and updates to privileges across enterprises. It's the best of both worlds: The information and functionality are centralized, but each entity maintains a clear view of their own medical staff’s privileging data.
Take the privileging process to the next level
Getting your providers credentialed and privileged quickly and with confidence is critical to maintaining patient safety, achieving clinician satisfaction, monitoring and achieving patient-care outcomes, and kickstarting the revenue cycle. An end-to-end electronic privileges and provider data management system streamlines the process and ensures providers deliver only those procedures and services they are competent to perform.
It’s also important to remember that the privileging process doesn’t end when a provider initially receives their privileges. An advanced privileging software technology solution allows organizations to manage initial and ongoing privileges with ease.
A few ways that advanced privileging software technology can help with end-to-end needs include:
- Allowing providers to make digital requests for specific privileges
- Approving requested privileges via the Committee Manager
- Identifying a privilege status: requested, approved, denied, not requested
- Providing a view into current and past versions of a practice area or privilege
- Linking CPT and ICD codes assigned to a practice area privilege
- Displaying granted privileges in real-time with an online privilege lookup tool
Robust software tools also make key information accessible to any authorized user who needs it, anytime they need it, keeping data centralized, streamlined, and easy to use. By allowing medical staff to accurately determine which providers have which privileges, users can schedule procedures quickly and without mistakes. In addition, healthcare leaders don’t need to worry that the floor staff won't receive updates about providers who have suspended or revoked privileges.
Privileging software technology can do it for you
Comprehensive software solutions also enable healthcare organizations to tie privileging documentation directly to ICD and CPT codes. Linking ICD and CPT codes to privileges allows users to generate reports from your healthcare organization's billing system, which will provide insights to important information such as how many procedures your providers are performing.
It can also help prevent providers from performing procedures in which they are not privileged. In addition, tying privileging documentation directly to ICD and CPT codes helps re-credentialing and reporting so Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE) can become more streamlined and efficient.
Finally, some providers also choose to incorporate quality review software into their privileging tools. It's a smart option, especially as reimbursement models evolve to value-based payment. Providers increasingly need to show increases in positive outcomes, making it more important to monitor, benchmark, and report on provider performance and outcomes.
That's where symplr Quality Review software comes in. It automates workflows for peer review, OPPE, and FPPE and gives insight for education and improvement. That way, your organization archives true provider-focused performance improvement.
Although privileging is complex and ever evolving, it's critical to achieving patient safety and reducing risk, and delivering optimal outcomes. That's why healthcare organizations shouldn’t trust their privileging process and requirements to outdated methods and tools and instead should employ strong privileging technology that ensures no physician or requirement falls through the cracks.