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blogpost 09072016

Penn Medicine Goes Paperless for Credentials Review Process

SITUATION

Penn Medicine at the University of Pennsylvania incorporates six facilities with over 4,000 credentialed providers. The Medical Staff Office (MSO) for Penn Medicine uses Echo as the source of truth for all provider information related to credentialing and health plan enrollment. Recently, the Penn Medicine MSO made a strategic decision to streamline and automate their processes. The credentialing review process — where an initial applicant or reappointment applicant is reviewed by the clinical department chairmen prior to presentation to the Credentials Committee—was an important part of that effort. The focus was on deploying an electronic process to eliminate inefficiencies in the series of interactions between the MSO and the Reviewers required to complete the credentials review process. They sought an electronic solution which would provide the tools to document the time required for each step and to identify opportunities to shorten and streamline the entire process.

Solution

Penn Medicine selected the Echo Provider Assessment Portal. It delivered exactly the electronic tools they needed to enable Reviewers to review and sign off on standardized credentials packet, an extract of the complete file, using a streamlined process. To deploy the Provider Assessment Portal, Penn Medicine conducted an evaluation of the documentation required for a successful review of a verified credentials application. In order to develop a paperless review process, all parts included in the packet needed to be electronic. That meant scanning of documents received during the verification process. Historically, all Penn Medicine credentials packets had been the aggregation of every component collected during the application and verification processes; with all the documents ordered in a generally consistent manner. With the guidance of the physician champions, each element of the file was reviewed for appropriateness with a keen eye toward what could be prioritized.

RESULTS

As a result of the evaluation, a Scanning Protocol Guide was developed. The guide identifies all documents to be scanned into Echo; the location in Echo for that type of document; the record Type in Echo (such as Medical School); the individual responsible for the scanning; the process the document is used to support; and any tips to make it easy for MSO users. The Scanning Protocol Guide is regularly updated so it is current and readily available to all Echo users as a reference. It is accessible to them both on a shared drive and as a link in Echo.

Next, streamlining the process required a method to flag components which should be brought to the attention of the Reviewer. In the paper method, sticky tabs were used. As a result of the evaluation, a Verification/Red Flag Checklist was developed in conjunction with the Credentials Committees and Medical Executive Committees. This ensured that vital information was incorporated into the electronic packet and flagged when necessary. Penn Medicine found there was a lack of uniformity in the previous, manual red flag review process. A positive benefit of this project meant that moving forward Penn Medicine Reviewers would be evaluating providers uniformly across the health system. It also clarified what was important for the MSO to provide to them as red flags. For example, the Reviewers always wanted to see reference verifications because they were able to “read between the lines” to glean additional insight from the responses.

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