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Columbus Children's Hospital Streamlines Telemedicine Credentialing
- 1. Joseph Zanga, MD, FAAP Chief of Pediatrics Columbus Children’s Hospital Columbus, Georgia Professor of Pediatrics - Mercer University School of Medicine 706 571 1220
- 5. Columbus, Georgia Area: 220.8 sq. miles (571.9 km²) Population: 202,824 (2013) Second largest city (not metro) in Georgia
- 8. The Why
- 9. Midtown Medical Center • Columbus Children’s Hospital and the Community: • 35 primary care pediatricians • Pediatric Emergency Center (PEC) • Regional perinatal center – 40 bassinettes • 21 Inpatient beds • 5 bed PICU • 5 bed stepdown/observation unit
- 10. We Have at the Hospital and in the Community: • Neonatologists (3) • Allergist/immunologist • Cardiologist • Critical Care • Endocrinologist • Gastroenterologist • Hematologist/Oncologist • Neurologist • Ophthalmologist • Orthopedist • Psychiatrist • Physiatrist
- 11. But We Still Needed Services for: Pediatric Nephrology Urology Child Maltreatment Dermatology And someone in every other service for which we had only one specialist
- 12. So We Wanted Backup in: Cardiology Critical Care ENT Gastroenterology Hepatology PM&R Psychiatry
- 13. However No One Wanted To Complete Our 47 Page Credentialing Packet and Provide All The Accompanying Documentation Required (24 Separate Items – plus $100)
- 14. The How
- 15. Official Publication of Joint Commission Requirements Final Telemedicine Revisions • Element of Performance for LD.04.03.09 A 23. For hospitals that use Joint Commission accreditation for deemed status purposes: • The originating site makes certain through the written agreement that all distant-site telemedicine providers’ credentialing and privileging processes meet, at a minimum, the Medicare Conditions of Participation at 42 CFR 482.12(a)(1) through (a)(9) and 482.22(a)(1) through (a)(4). • If the originating site chooses to use the credentialing and privileging decision of the distant-site telemedicine provider, then the following requirements apply:
- 16. • The governing body of the distant site is responsible for having a process that is consistent with the credentialing and privileging requirements in the “Medical Staff” (MS) chapter (For more information, see Standards MS.06.01.01 through MS.06.01.13). • The governing body of the originating site grants privileges to a distant-site licensed independent practitioner based on the originating site’s medical staff recommendations, which rely on information provided by the distant site.
- 17. There is Another Section APPLICABLE TO CRITICAL ACCESS HOSPITALS
- 18. Medical Staff (MS) Standard MS.13.01.01 For originating sites only: Licensed independent practitioners who are responsible for the care, treatment, and services of the patient via telemedicine link are subject to the credentialing and privileging processes of the originating site. Element of Performance for MS.13.01.01
- 19. The Next Step
- 20. MMC Staff By-Laws Telemedicine: Medical practice is defined as any contact that results in a written or documented medical opinion and affects the medical diagnosis or medical treatment of a patient. Telemedicine is the practice medicine through the use of electronic communication or other communication technologies to provide or support clinical care at a distance. The Joint Commission and the American Telemedicine Association define telemedicine as the use of medical information exchanged from one site to another via electronic communications for the health and education of the patient or healthcare provider and for the purpose of improving patient care, treatment and services
- 21. • 3.2.1.1 If the applicant is a telemedicine Practitioner located in a different State the applicant must also possess current, unlimited, unrestricted, active licensure in that State as well as in Georgia.
- 22. Telemedicine Privileges Practitioners who wish to provide telemedicine services, as defined in these Bylaws… shall be required to apply for and be granted clinical privileges for these services as provided in these Bylaws The Medical Staff shall define…which clinical services are appropriately delivered through a telemedicine medium… The following credentialing procedures shall be followed:
- 23. • 5.2.11.1 When a telemedicine provider is providing services from a different State, licensure and/or other requirements that may be imposed by a State will be verified for both the State where the Hospital is located and the State where the Practitioner is located. • 5.2.11.2 Specific to telemedicine providers, due to extraordinary high number of healthcare affiliations, queries will be limited to the top five high volume affiliations and any healthcare organization from which the Practitioner was reassigned during the last five years.
- 24. With All That In Place • Application received in Medical Staff Office • If complete is referred to Pediatric Credentials Committee • If approved: Is referred to Medical Staff Credentialing Committee Then is referred to Medical Executive Committee • Final approval is by the Board of Directors
- 25. Remember No One Wanted To Complete Our 47 Page Credentialing Packet and Provide All The Accompanying Documentation Required (24 Separate Items - plus $100)
- 26. Credentialing By Proxy • Copy of Health Care Facility (JACHO) approved delineation of privileges form for provider • Provider Summary Page (to include educational background information) • Certificate of Malpractice Insurance • State License Verification • DEA Verification • Board Certification Verification • CV
- 27. So Now We Have 15 Telemedicine Physician Consultants on Call Heavy Cardiology Concentration Still need: Dermatology Infectious Disease Rheumatology ??