Written by Dave Shafer

When one of the largest academic institutions in the Southeast announced the acquisition of four hospitals in 2018, the medical center knew it already had the all-important credentialing solution onboard to handle the new clinicians who would be joining the medical center.

It’s the same tool that had helped rescue the 700-bed center during a turbulent time a decade before: Verge Health’s Credentialing and Practitioner Performance solution.

Prior to Verge Health’s partnership, the hospital had been experiencing a high rate of staff turnover, and surveys showed poor performance for its 1,300 practitioners, according to the medical staff affairs-credentialing manager. The credentialing system had been focused primarily on physicians rather than the allied health disciplines that were making up much of the primary-care and specialty-care networks beyond the hospital. Staffs were duplicating credentialing efforts in both the practitioner offices and the separate business offices.

Managing practitioner performance and credentialing had involved tedious, time-consuming manual processes. Feedback from medical staff had been the only source of data, and capturing that feedback involved inefficient and error-prone paper reports. Achieving a quorum for credentialing committee meetings was difficult, and those meetings often took four hours, during which members would review 60 to 70 files.

Chris Malanuk

The medical center had needed a way to pull more accurate data and a more effective process for managing provider performance and credentialing, including for its telehealth providers. After analysis, the team had deployed the Credentialing and Practitioner Performance solution from Verge Health, which streamlines credentialing workflows, provides self-maintenance tools for practitioners and a comprehensive peer evaluation, and centralizes credentialing data sources. Those are all important elements of maintaining quality outcomes, practitioner satisfaction and an exceptional patient experience, according to Chris Malanuk, Verge Health’s president.

Now the medical center’s credentialing, staffing and performance issues are a thing of the distant past.

A Common Problem: Credentialing Short-Sightedness

These credentialing problems weren’t unique, Malanuk said.

“For years, credentialing has been something that has been a little more perfunctory than we would like or intend,” he said. “It has been about license-checking and simply making sure the individual is going to be board-certified.

“Until recently, health care systems weren’t trying to capture a person’s performance and the role a practitioner plays in its claims or adverse events or regulatory and accreditation risks. They simply didn’t measure the right criteria.”

Much of the reason for that was because collecting that information in a causal format was difficult, he noted. Hospitals used disparate systems for administrative, regulatory and patient safety information, and those systems didn’t share information.

Verge’s Credentialing and Practitioner Performance solution solves that disconnect. Its integrated platform ties together patient safety, regulatory and practitioner information in a single domain. That provides hospitals with a deeper view of how practitioners and processes are affecting compliance and events.

“You’re not only looking at people,” Malanuk said. “You’re looking for process issues, too. And the best way to do that is to go more global with your information. You share this data and let it cross-communicate from one module to the next.”

Verge Health set out to create tools that can fit in the hands of the day-to-day reporters and observers of what’s going on in the organization, and to help them report and record compliance issues and see the results, Malanuk said. The Credentialing and Practitioner Performance solution has built-in utilities around regulatory compliance that are tied to accreditation standards. A provider or other staff member who uncovers an area of risk can assess and use mobile platform tools to document and fix the issue.

“That drives a sense of engagement and continuous compliance,’” Malanuk said.

Standardized, Digital and More Efficient

By partnering with Verge Health, this growing medical center has created a more strategic approach to credentialing and onboarding of practitioners.

It now manages credentialing files for nearly 1,800 practitioners within one system, which has increased efficiencies while maintaining quality across the enterprise. All its provider information is standardized and digitized. Credentialing staff can review files in advance of meetings so they have more time to study details and identify flags.

As a result, meetings went from four hours to just 15 minutes and have become more of an interdisciplinary committee. That allowed the hospital to shift its focus in the meetings to discussing policy issues, competency requirements and privileges.

“One of the primary reasons I accepted my current position is because of the Verge Health Credentialing solution,” said the credentialing manager, who has been charged with driving the credentialing process for the acquisitions while maintaining its existing credentialing operations. “I have seen firsthand how the solution has transformed our practitioner management program, and I know the commitment Verge makes to its clients’ success, which is going to be an instrumental part of our acquisition strategy.”

Paper-based Systems in the Newly Acquired Hospitals? No Problem

“Most of the new hospitals have the appropriate credentialing procedures, but those procedures are generally paper-based. We needed a process that allows us to bring on the very best practitioners quickly so as not to compromise patient care in the process,” said the credentialing manager.

The Credentialing and Practitioner Performance solution lets the medical center streamline the transition to digital processes and drive quick adoption of credentialing tools by newly acquired staff and practitioners. Feedback from the newly acquired providers has been positive, the credentialing manager said.

“Having a central repository for all provider information makes for a smoother, faster onboarding process, and the digitization of processes requires fewer resources, which translates into significant cost savings.”