May 15, 2020, 12:39 PM
Looking to the future of Medical Staff Services over the last 30 years. What led us to where we are today and what will continue to drive us onto new horizons.
I saw the recent NAMSS announcement regarding Become Tomorrow's MSP Today. It made me stop and think about how this profession has changed since I entered it more than 35 years ago. I believe that the ongoing COVID-19 pandemic has made many of us reflect on our personal and professional lives and what lies ahead.
Personally – I have always known how important my family is to me, but recent events have brought us all closer together even though we aren’t able to be physically together. I will never again take our time together for granted – and especially the ability to share a meal and hug.
When I think about how the medical services profession has changed over the past 30+ years, I think that changes have occurred for the following reasons:
Drive for recognition from within the profession.
Individuals within the profession recognized the importance of the services that they were providing and pushed for recognition and a voice. They came to be perceived as doing much more than just performing a clerical function. Today, many MSPs are in executive/management positions – and with the education credentials to match. The National Association Medical Staff Services has grown along with the profession to more than 6,000 members.
Recognition of the importance of credentialing and privileging.
Making sure that providers are competent is much more emphasized today than it was in the past. In the past, credentialing and privileging was something that organizations did to pass a survey. Providers routinely were granted temporary privileges before any primary source verification was completed. Today, credentialing and privileging is what we do to assure competent care to patients. Privileging today is much more rigorous than it was in the past. Years ago, privileges were a laundry list that frankly, no one paid much attention to. Privileging is now perceived to be a cornerstone of an organization’s quality improvement processes.
One of the huge changes that has occurred was the realization that in order for an organization to get paid, providers needed to be credentialed. And with the increased number of employed providers, the importance of getting the credentialing process done in a timely manner became a focus of attention by the C-suite. This makes it challenging for those who are responsible for management of credentialing and privileging processes – how to speed it up, without sacrificing quality.
Software vendors rose to the occasion and developed tools that automated credentialing and privileging. Organizations were more willing to pay for the software because the benefits of automation include faster credentialing and the need for less staff. MSPs who have embraced and mastered the use of new technology have been more successful than those who have resisted optimizing the use of technology.
Emphasis of onboarding.
As mentioned previously, the employment of providers has driven organizations to complete credentialing faster. It has also made organizations address onboarding procedures – to organize the processes involved in recruitment, contracting, credentialing, orientation, etc., into a more coordinated and synchronized process in order to achieve less duplication of activities and a higher degree of provider satisfaction. This has allowed MSPs to expand the services offered by their department beyond traditional credentialing and privileging.
Source of truth.
Provider data maintained in the credentialing database is aspired to be the source of truth throughout an organization and is downloaded into other business applications, including the organization’s patient record system and billing system. This has increased the importance of the provider data and those individuals who collect and maintain that data.
Mergers and acquisitions.
M&As have created new job opportunities for those MSPs who have the education and experience to take on new roles. Almost all health systems include a CVO (credentials verification organization) which offers a job opportunity for manager/director of the CVO. Health systems also are large enough to include a system-level database administrator to assure that all components of the system adhere to use of the credentialing software in a way that meets organization objectives. Frequently, enrollment services are included in the scope of the CVO services which offers additional job opportunities. Additionally, a system level executive position responsible for oversight of the CVO services and also individuals who work the hospital medical staff offices is becoming the norm. Finally, there is an emerging position for an individual (usually clinical) who is designated responsibility for managing the privileges for the health system (frequently this individual is hired to assist with standardization of privileges across a health system).
So – given all these changes, what is ahead for MSPs? If we have learned one thing from COVID-19, it is probably that situations can change rapidly. Nothing is carved in stone. That being said, however, here is what I predict about the MSPs of tomorrow and how they will work:
- MSPs will have more education with many positions requiring a minimum of a bachelor’s degree and a master’s degree required for management positions.
- There will be more positions that require clinical experience – these positions will support privileging, ongoing assessment of clinical competence and peer review.
- There will be more positions that will require proficiency to mine, analyze and report data. Predictive analytics will be part of the skill sets necessary for the increasing number of data positions.
- There will continue to be standardization of credentialing and privileging in health systems. Because of the ability to connect electronically with providers for meetings, and for evaluation of credentialing and privileging, the number of medical staff offices in hospitals will decrease, with the work centralized at the system level. The days of physicians coming by the medical staff office to review a paper file (and the MSP showing the physician where to sign) are pretty much over.
- Many individuals will continue to work from home – the necessity to work exclusively from an office has proven to be unnecessary for those organizations that have software that facilitates electronic credentialing and privileging as well as electronic review and evaluation of credentials files.
We have experienced, with COVID-19, how quickly changes can occur. For example – many MSPs recently went from working in an office every day to working from home overnight. We are resilient! And – we know how to work with providers. This profession is never dull – and it will continue to offer the diversity of work and stimulation that will attract the next generation of MSPs to carry on the important work of credentialing and privileging!