INTRODUCTION



RECORD OF PROCEEDINGS

NATIONAL CREDENTIALING FORUM (NCF)

SCOTTSDALE ARIZONA – LA POSADA RESORT HOTEL

February 20 – 21, 2004

INTRODUCTION

All welcomed to 2004 NCF by Carol Walker, Director, El Paso County Medical Society, Colorado. Diane Oeste, Privacy Officer, Director MSS, Maryvale Hospital Medical Center, host organization for NCF, welcomed all to Scottsdale.

GENERAL INFORMATION / ANNOUNCEMENTS via Round table / getting to know each other:

- Federation of State Medical Boards (FSMB); annual conference will be held in Washington, April 30 – May 2, 2004; one of the speakers will be Rosemary Gibson, author of Wall of Silence, (if you liked Blind Eye, consider reading this book)

- Physician Assistant Profile has been launched by the AMA

- NAMSS annual conference will be held in Miami, Florida, September 20 – 22, 2004

- List of invited and attending participants will be updated and distributed by Carol Walker

- CEUs have been provided by NAMSS for participation in the Forum this year

CORRECTION TO MINUTES OF NCF 2003 - per Tim Knettler, FSMB; 2003 minutes stating that it takes 60 days for national information and 70 days for international information to get into the database is incorrect. It is corrected and clarified to state:

All state medical boards and the international regulatory agencies (Canada, England, New Zealand, and Australia) report disciplinary actions to the FSMB in days to weeks. There are outliers at times, but the boards have gotten very timely with their reporting as they receive disciplinary alerts from FSMB when a licensee receives an action from another board. In addition, FSMB distributes to the media an Annual Statistical Report that shows the number of actions taken by each board for the year. This, along with periodic verification checks with the boards and the alert service provides a comprehensive look at actions for each board, each year.

Image Tag Inc. – Steve Irons ()

Image Tag is the sponsor of the Forum this year; information presented by Mr. Irons re the product included:

- Kwik Tag is a system patented by Image Tag that moves paper into digital files; it provides the ability to file on the network

- The product is currently in use at Tucson Medical Center

- Uses a digital version of the post-it-note

- File – tag – scan; can retrieve data via bar code

ACCREDITATION UPDATE: ANSI – American National Standards Institution – PERSONAL CERTIFICATION PROGRAM presented by Stephen Permison MD

- Purpose / mission: enhance the global competitiveness of US business and the American quality of life by promoting and facilitating voluntary consensus standards and conformity assessment systems and ensuring their integrity.

- There is wide diversity in certification programs

- Potential credentialing product is national and international and it is driven by economics

NAMSS CREDENTIALS ELEMENTS TASK FORCE – presented by Christina Giles, President, Medical Staff Solutions. Handouts distributed (may be obtained from Carol Walker via e-mail).

Ms Giles noted that the National Association Medical Staff Services (NAMSS) commissioned a Credentialing Elements Task Force in June of 2003 to identify the critical data elements to be included in all application processes.

- The NAMSS White Paper / position paper is on the NAMSS web site

- NAMSS members have been encouraged to utilize the key elements as a tool to evaluate credentialing applications

As there are now 2 application / core elements (NCF and NAMSS) for consideration:

o will we continue to update / revise / maintain the NCF form, or

o will we endorse the NAMSS elements, or

o attempt to work jointly with NAMSS on some changes

Following discussion it was agreed to:

o recommend development of a marketing plan for distribution of final application / elements

o offer support (1-2 volunteers from NCF) to work with NAMSS and seek continued collaboration

o recommend development of core elements for non-physician applications as an addendum to the current document

JCAHO ACCREDITATION UPDATE – presented by Robert Wise MD., VP of Standards, JCAHO. Using a PP presentation Dr. Wise addressed several topics including:

- Telemedicine: originating site and distance site

o The treating physician (writing orders on the chart) – is addressed in MS standard; and the interpretive reader in the Leadership standard

o New issue: verification of identity; no answer at this time

o Sub contracting issue; hospital sub-contracting to a group and the group then sub-contracts to another group – second group must meet all of same requirements

- Credentialing and privileging non-LIPs:

o New requirements for non-LIPs with supervisory / collaborative relationships - affects PAs and APNs

o Recognition of role of PAs and APNs

o PAs all supervised by MDs, while APNs differ by state

o All must be credentialed and privileged (doesn’t matter what you call it – is privileging)

o Equivalent process, if not a mirror process, at minimum includes:

▪ Evaluate credentials

▪ Current competence

▪ Peer recommendation

▪ Communication among individuals and committees to make informed decision of privileges – it is not required that the MEC makes a recommendation

▪ Cycle time needs clarification

- Important changes

o Believe have removed all the redundancy; goals of standards changes were to clarify, simplify, and remove redundancies

o H&P – collapsed into a singe requirement

o MS.2.20 – management of patient care – must have communication among all practitioners involved in one patients care

o Performance Improvement – use of information

▪ Use of adverse privileging decisions

▪ Sentinel event data and resulting RCA

▪ Patient safety data LD 4.40 – medical staff should be part of leadership

o credentialing process safeguard

▪ protection against “identity theft”

▪ mechanism is used that ensures individual requesting privileges is the same

o unusual pattern or excessive number of professional liability actions

▪ information considered when granting, renewing or revising privileges

o unilateral amendment MS.1.1.1 – current standard has been left unchanged

o LIP must be aware of any limitation of privileges of non-LIP he / she supervises

- Future issues – current discussion with Expert Panel

o Standardized methods of determining competency for privileging

o Determine procedures when implementing new procedures

o Qualifications / competency of individuals providing education and / or proctoring

o Broaden dimensions to require the practitioner’s effective participation within the healthcare team

NCQA ACCREDITATION UPDATE – presented by Frank Stelling, Policy Manager for NCQA, Handout distributed. Mr. Stelling provided an update on CVO survey process and credentialing standards:

- 2004 MCO standards - changes

o Documented process to ensure accuracy of member materials (CR1)

o Committee must only review credentials that do not meet criteria (CR2)

o Verification of licensure becomes separate element (CR 3& &) standard not changed, but is a separate element – due to importance

o Review of quality issues in CR 9 incorporated into CR 10

- 2004 CVO standards - changes

o Changes in scoring

o 3 core standards are now ‘must pass’

- Changes in survey process / survey tool

o Moving from paper based process to web based tool

o Provides a readiness tool – a pre-survey self assessment tool

o Organization will be able to get numeric results based on survey

o Will link supporting documents (policy and procedure) to show compliance

o Will have off-site review (non-file review standards)

PAPERLESS CREDENTIALING INITIATIVE for the state of Massachusetts – presented by Andy Lock, WinStaff. Handout distributed.

- For purposes of this presentation paperless credentialing was defined as

non-paper application from the applicant to the organization

- Mr. Lock outlined the development of a paperless application for the state

of Massachusetts

ACCREDITATION UPDATE: ABMS AND AOA BOARD CERTIFICATION REQUIREMENTS – presented by Annette Gippe, American Osteopathic Information Association. Handout will be available. Information covered by Ms. Gippe included:

- Information may be submitted to AOA from ACMG courses which is then converted by AOA as equivalent

- Letter indicating that the board was passed, is not certificate, there is a meeting by the Bureau of Specialists who determines certification

- AOA does have a board eligibility – 6 years

- A more continuous approach to maintaining certification is being developed by boards (vs. one recert exam)

ACCREDITATION UPDATE: NPDB and HIPDB – presented by Jody Schirling, Nemours Foundation, Chairperson, NPDB Executive Committee, and Betsy Ranslow, Sr. Associate for External Relations, Division of Practitioner Data Banks, Health Resources and Services Administration. Handout provided. The PP presentation by Ms. Schirling and Ms. Ranslow noted:

- A number of personnel changes

- PDS – proactive disclose service under consideration; concept is that a group of practitioners could be registered with the Bank, if any action / change with a practitioner, it would be reported to group

- Revising Guidebooks, and will add a Table of Contents and an Index

- Health Plan letter recently distributed re reports required for practitioner changes in Plan participation

- Annual reports will be posted on web page very shortly

- New on-line brochure re self-query

- White paper being developed regarding residents / responsibility

- Excellence in Government – Data Bank received an award for use of technology

- Working with state boards re reporting actions to HIPDB

- MMPR form changed

- A number of system changes have been made to make it more user friendly

NAMSS INFORMATION – presented by Cris Mobley, NAMSS representative to NCF. Information from Ms. Mobley included:

- CSMC certification title has been changed to CPMSM – Certified Professional

Medical Services Management to better reflect the work, scope and focus of the medical staff office manager

- Certification Board is changing the focus of the exam for CPMSM

PANEL DISCUSSION – CENTRALIZED CREDENTIALING - WHERE IS THE INDUSTRY / WHERE SHOULD IT BE / WHERE WILL IT BE 5 YEARS FROM NOW?

Brief presentations were made by:

Kate Enchelmayer, Vet Pro; VA System, not centralized credentialing – but electronic credentials / verifications are centralized; lessons learned - in addition to physicians, medical staff office has to see the value - software has to build trust and staff needs to be involved in software development, physicians must believe system is secure; many locums – centralized works well for locums; 3 -5 years needed to implement

Lynn Buchanan. Buchanan and Associates Consulting; in work with clients, sees a lot of confusion in the industry; many don’t differentiate between verification and credentialing; see movement to centralized and standardization; to be successful, needs to be invisible to the process.

Jana Darnell, ACS MIDAS+; software vender with product of a single record of information / data; IT departments are driving centralization in many areas, standardization an issue and a need, will see an increase in outsourcing; to be cost effective must use same form ; see an increase in centralized credentialing with larger databases; need national recognition of needs and requirements

Linda Hack, Aurora Health Care System CVO; From perspective as manager of CVO for a large healthcare system with hospitals and large health care network; privileging, peer references and NPDB is retained by each entity; do a lot of scanning; are currently involved in putting privileges on line; long term looking to total paperless; challenges – 3rd party involvement, rising costs; looking to on-line application.

Lynn Stockton, Checkpoint CVO; Sees CVO is a data collector, medical staff services should be doing credentialing and privileging, all CVOs are not the same in terms of services and timeliness, driven by volume, will see a lot of consolidation of services in the future.

(INSURANCE) FROM THE OTHER SIDE: responding to professional liability insurance verification inquiries impacts PLI companies. Presented by Mary Hedin, VP Underwriting and Ron LeBrun, VP Information Technology, MICA / Physician Insurers Association of America.

Ms. Hedin and Mr. LeBrun provided information regarding a program their company has initiated to address the needs of the organizations making the largest number of requests for information.

LEGISLATION / REGULATORY UPDATES: presented by Tim Knettler, President Federation State Medical Boards; Handout provided. Mr. Knettler addressed:

- State licensure, how it relates to telemedicine

o The practice of medicine is deemed to occur in the state where the patient is located

o 9 states have special purpose licenses (are not limited to telemedicine) which relate to medical care of patient located in one state by a physician located in another state

- Licensure by endorsement / reciprocity – portability

o Under development; special committee policy report

o Look to common license application forms and standardized system of credentials verification

- State medical board criminal background checks differ across the country

- Other national issues identified as

o Emergency preparedness

o Patient safety / medical errors

o Scope of practice

o Maintenance of licensure

IDEAS FOR FUTURE CONFERENCES / PROJECTS / ISSUES

- Quality of data

- PIAA – use of electronic verifications

o Group to interact with PIAA

- Advisor group for FSMB - web site

o To Cris / Carol if interested in support

- Education white paper credentialing / verification

What are we doing with the core data tool?

- MSCVO developed the original core data set; the NCF revised the set, NAMSS developed core data

- Now needs to be tweaked, combined, some update – now needs to be operationalized

- Next step – verification

- How is staff (who actually performs the credentialing) supported

FUTURE OF NCF

What is stated purpose of this organization?

- Influencing the key stakeholders of credentialing

- Influence policy

- Collaborative work

- Education / information sharing among group

- Consensus building

- Think tank

- cross representational

- to provide White papers or commentary on issues / changes – to feed info to appropriate agencies

- Structure agenda with facilitator, come to conclusion or consensus

What does NCF want to be?

- Information gathering / sharing – majority agrees

- Consensus building – some agree

- Advocacy / influence – majority agree

- Policy development – few agree

What is this organization – how do we find out

- Andy will build web-site

Meetings:

- Do we want to meet 2x a year – no

- Dates for next meeting: February 11 – 12, 2005

Plan for 2 full days

- Host organization – California; Andy Lock, Lynn Stockton, and Vicki Searcy will host 2005 meeting

- Cris Mobley will assure continued organization and preparation for 2005 meeting

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download