Friday, May 19, 2017

(Video) Be a Super Hero - Accelerate Turnaround Time for Provider Professional Reference Checks

Professional references are a key component to the credentialing effort as they offer the opportunity to attest to the current clinical competency on any provider making initial appointment, and or at the time of reappointment if new clinical privileges are requested.

The Joint Commission standards require a professional reference to address these six separate competencies:

  • Medical/Clinical Knowledge
  • Technical and Clinical Skills
  • Clinical Judgment
  • Interpersonal Skills
  • Communications Skills

Professional references often include reference letter(s), or written documentation (questionnaires) about the applicant from a peer (practitioner in the same professional discipline as the applicant) who has personal knowledge of the applicant.

Are you faxing your questionnaires or sending PDFs of the questionnaires to referencing providers in a email and asking them to send back their responses? How long does it take you to contact professional references for your providers and to get information back? Days? Weeks? How much time are you spending following up with these providers?

There is a better way! Accelerate turnaround time of reference questionnaires with Echo Survey.

Click here to learn more about how you can speed up your provider reference survey process or call us at 1-800-733-8737.

Tuesday, May 16, 2017

Are You A Provider Enrollment Specialist? We Need Your Input!

Traditionally, hospitals, healthcare organizations, and medical groups have viewed provider enrollment in health plans as a back-office function, lacking strategic importance. More recently however, a number of changes in the industry have caused this function to be viewed in a much more important light.

#1 - Hospitals, healthcare organizations, and large medical groups have employed providers in record numbers, taking on the responsibility of their credentialing and provider enrollment.

#2 - Credentialing and enrollment processes are woefully inefficient in light of current volumes and reporting demands.

#3 - Hospitals, healthcare organizations, and medical groups are actively seeking solutions that will improve efficiency and revenue cycle management.

Against this backdrop, for the past two years we have embarked on examining the current and changing environment for provider enrollment and the implications it has for hospitals, healthcare organizations, and medical groups. Collecting input from provider enrollment specialists like you to benchmark industry data and showcase important industry trends that affect your profession.

Once again, we are preparing our 2017 report on provider enrollment and can use your help. If you are a provider enrollment specialist with a hospital, healthcare organization or medical group, please take a few minutes to help us understand your role and the changes affecting provider enrollment within your organization.

Tuesday, May 9, 2017

(Video) - How to Automate Provider "Good Standing" Requests

In a survey conducted with 915 National Association of Medical Staff Services (NAMSS) members, only 19.5% have fully and successfully implemented automation to reduce credentialing and  re-credentialing time frames.

One of the less automated functions being conducted is third party verification requests. Our research shows, that medical staff offices are spending too much time manually responding to third party requests for provider in “good standing” information.  

Is this happening at your facility? How much time are you spending on this activity?

Watch our latest video "How to Automate Provider "Good Standing" Requests to learn how Echo's 3rd Party Verification Portal can free up staff time for those higher priority tasks.

Why not get started today in eliminating those extra emails and phone calls. Contact us to learn more. Please mention 3rd Party Verification Portal with your request.

Monday, May 1, 2017

Ten Years of Ongoing Professional Practice Evaluation (OPPE) - What Have We Learned?

Guest Post By: Vicki Searcy, Vice President, Consulting Services, Morrisey, a HealthStream Company

The Joint Commission announced the requirement for OPPE in 2007, in order to give organizations time to formulate their strategies for compliance by January 1, 2008 (the date on which OPPE requirements became effective).  We are now in our 10th year of being required to have an OPPE process in place.

What have we learned during the last 10 years?

1. OPPE is a component of privileging.  The reason requiring OPPE is to compel organizations to use data to evaluate practitioner competency specifically related to the exercise of clinical privileges.

2. Performance reports must be focused on the privileges that are granted - therefore, they must be specialty-specific.

3. More comprehensive clinical activity reports are necessary in order to evaluate a practitioner's activity within an organization.  It is insufficient to just identify numbers of admissions/discharges, consultations and total number of procedures.  This does not meet Joint Commission requirements.  It is necessary to collect numbers on the types of procedures performed, etc.  Matching procedures performed to privileges granted is essential.

4. The definition of competency has forever been expanded to include more than technical expertise.  We now include other factors in evaluation of competency - such as professionalism, interpersonal and communication skills, etc.  Organizations are now incorporating information about a practitioner's ability to work well with all caregivers and communication with patients into OPPE reports.

5. Organizations are better served to start small and build on a solid foundation rather than to try to include too much data on reports.  A Joint Commission finding has been that some organizations put a robust policy and procedure in place and then are unable to meet their own requirements.

6. Collaboration from the Medical Staff Office and Quality Management Department is essential to support the process of implementation of meaningful performance reports.

7. Organizations either need to establish thresholds or targets - or analyze each and every performance report in order to identify data that is out of the norm.  It is much less work in the long run to establish targets.

8. OPPE is applicable to any practitioner granted clinical privileges, including physician assistants and advanced practice registered nurses.  OPPE data can be difficult - but not impossible - to collect for these practitioners.  In many cases, data is difficult to collect because of how the organization decided to implement the electronic patient record (i.e., defaults to attending/admitting practitioner rather than to the practitioner - such as a nurse practitioner - who provided the care/service).

9. Sometimes it is not feasible to attribute data to a specific practitioner - the data is more relevant to a team or group.  Astute organizations are working to develop and use team data.  This is also relevant to some privileges that are team procedures rather than a practitioner-specific privilege.  Stay tuned for more information as this continues to evolve.

10. An indicator data dictionary is needed in order to define each indicator that is used in OPPE reports.  For example - an indicator such as "unexpected death" must be defined so that all users/participants in the process of OPPE would know what data would be consistently included.

11. Most organizations are sharing performance information with their practitioners.  In order for practitioners to improve performance, they need to know how their performance varies from their peers.

12. Organizations that contract/employ practitioners want to use the same reports for performance evaluations for "HR" and privileging/OPPE.  This dual usage requires that great care be taken related to how reports are generated, used and maintained to avoid discoverability issues.

Many more lessons have been learned during the past 10 years - and it is certain that organizations will continue to learn how to conduct effective practitioner performance evaluation.

I'd love to hear from organizations that have OPPE success stories to share.