The Evolution of the Credentialing Solution Space

Original article by Thomas Finn

Medical credentialing is a generally accepted good practice that hospitals undertake to verify who works for them and, as a rule (thank goodness), most all of them do it. While the storage and management of such data so they can be accessed by employers, insurance companies and professional organizations is not new, how the market’s leading solution providers have re-scoped the space definitely is.

The “credentialing solution space” is evolving in ways that are both fascinating and timely. Beyond appreciating why hospitals have a need to know who’s walking around their facilities, the current state-of-the-art is about managing all the individuals who touch the healthcare setting (inpatient, outpatient, visitors –i.e. the entire hospital ecosystem). Moving to a higher standard makes sense, especially in light of current patient safety economics. But to more fully appreciate why, health system executives must refresh their thinking. The thought leaders have changed the game and the latest solutions reflect it.

Where We Are: So we’ve moved from basic medical staff credentialing to vendor credentialing. These days, both application areas are approaching common practice. In fact, vendor credentialing has become an accepted requirement for doing busi ness with most larger hospital systems. In addition to qualifying each vendor’s business, their sales representatives are now being credentialed. While the focus has been on making sure that “reps” have had their shots and don’t have scary personal histories, how they’re managed from a facilities access perspective is yet another story. But access control solutions should not be standalone. They should be part of an integrated system that solves for the “community context” mentioned above.

Where it’s Going: In addition to health care’s economic challenges, natural disasters and terrorism have also impacted the current solution thinking. When a natural disaster occurs and emergency services are overrun, doctors, nurses and other caregivers must have the ability to move as necessary to meet patient demand. In the midst of such bedlam, their qualifications must be instantly accessible and/or verifiable.

What about terrorism? There are now solutions that allow potential scenarios to be modeled. And while some of these applications are currently sold as features of risk management offerings, there are credentialing companies currently moving down this path as well. And why not? The latest solutions already know who you are, they store and monitor your access privileges, they are integrated with security and send alerts when conditions are violated.

Of course, not all contingencies are so dramatic. What if I simply want to stop a crazy family member from visiting me? Visitation management is yet another application that naturally falls under the credentialing umbrella. White listing (who’s allowed to visit) and black listing (who’s not allowed) represent the most basic security measures hospitals can take. And yes, there are certain credentialing companies that are now integrating the capability.

Physical sensors, other types of monitoring equipment –even personal devices– are finding their way into the solution mix. Imagine cell phones becoming tracking devices. Imagine sensors that ensure hand washing and other personal hygiene procedures are followed. Imagine bio-metric keys and other devices used to log and control access across facilities. It’s happening.

Could your credentialing system have an impact on HAIs?

In summary, providers shopping for credentialing solutions would be well served to think beyond traditional solution boundaries. They need to think bigger. The space is rapidly evolving. From medical credentialing to vendor credentialing, visitation management, risk management, sensor-based systems that drive compliance, bio-metric keys, cell phones as tracking devices, etc. –the list is growing and market leaders are integrating these capabilities into managed SaaS offerings.