The Value of Credentialing

Credentialing is a vital area in healthcare. Whenever facilities bring on new physicians, the facilities have to verify their credentials. Otherwise, if the physicians were to practice without having the right credentials, the facilities would be guilty of malpractice and be denied reimbursement—both things that most organizations would probably want to avoid.

There are a lot of intricate facets to credentialing, including onboarding, privileging, and recredentialing, and with complexity comes difficulty. As KLAS discovered in last year’s credentialing report, there are a lot of vendors who provide credentialing solutions. But since that report, KLAS has published a new report that follows up on those vendors and reveals which solutions are addressing the issues surrounding this area.

Automation Integral to User Success

During the making of this report, several medical staff professionals were asked about the biggest challenges surrounding credentialing, and automation came up time and time again.

Historically, credentialing has been a manual process. Automating that process can be a very difficult thing because, as mentioned before, credentialing encompasses a lot of tasks. Medical staff professionals use credentialing software not only to onboard new physicians but also to track and recredential working physicians. All these processes involve lengthy timelines; onboarding alone can take up to six months.

With that in mind, automation is definitely a top priority for users when looking at credentialing solutions because it can make them more efficient and help them avoid potential malpractice cases. Automation can’t solve every pain point, and there are a lot of things that medical staff professionals can do to help streamline the credentialing process, but automation can help fill in gaps and alleviate the burden on those professionals.

A Single Source of Truth

For provider organizations, having a credentialing platform that can act as a single source of truth is an invaluable asset. According to KLAS’ new report, “Organizations without a single source of truth often struggle with duplicative or conflicting information.” And in an area where inaccuracy can lead to lawsuits, missed revenue, and patient injuries, medical staff professionals need to be able to trust their credentialing platform as the source of truth.

Integration can make a big difference in terms of users seeing their platform as a single source of truth. Organizations want to have comprehensive data across all platforms, and integration can allow other systems, like EMRs, to use data from credentialing solutions so that everyone is on the same page.

However, a credentialing platform being the single source of truth is also largely driven by the provider organization that is using it. More than anything, medical staff professionals find value in being able to control the data that goes into their credentialing platform. Free of outside influences from other departments, credentialing staff members can trust that information is correct because it comes directly from the physicians.

Valuable Relationships Lead to Valuable Solutions

One of the biggest findings from this report was the strong correlation between product value and vendor relationships.

Based on the provider responses, the vendors whose products had the highest value ratings also had the highest ratings for customer loyalty. While this correlation may seem obvious, it reiterates the fact that having good software is not enough; vendors also need to address issues and work with customers.

In an area as complex as credentialing, good support is necessary to enable users to streamline their workflows and become more efficient. And as the credentialing market continues to become more mature, the vendors that address pain points will differentiate themselves from those that do not.

What’s Next?

Credentialing is often overlooked by healthcare professionals who don’t realize its importance—sometimes even healthcare executives do not realize that credentialing is the foundation of everything that happens within a hospital. But credentialing shouldn’t be overlooked because medical staff professionals need the support from their organizations.

Looking toward the future, credentialing platforms’ automation and accuracy should continue to improve as vendors continue to support their customers and address the current pain points. And hopefully those things will lead to a less-siloed medical staff office that connects credentialing to a wider quality process. Ultimately, improving and streamlining that process will lead to the most important thing: improved patient care.

For more information on vendor performances and scores, please take a look at the full Credentialing 2019 report.