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How Credentialing Processes Must Evolve in the Age of Telemedicine

Hospitals and clinics are integrating more tele-services into their everyday protocols as the telemedicine model continues to demonstrate the potential for them to deliver better, more cost-effective care. However, while new protocols for providing quality care are rapidly evolving, many organizations continue to follow internal credentialing bylaws and standards developed to support a dated paradigm.

By establishing standards that differentiate between tele-providers and traditional onsite care providers, many medical staff offices are reducing administrative time and expense for credentialing. Following are some things every hospital and clinic should consider to bring their credentialing practices into the telemedicine age.


Why telehealth is different

Credentialing is designed to protect patients and staff by ensuring each facility has taken steps to minimize threats to safety – containing the risk of infection, prescribing and managing treatment options effectively, responding appropriately to emergent situations, etc. Traditionally, credentialing bylaws and standards are written under the assumption that each physician, nurse and administrator is at times occupying and maintaining the same physical space as patients.

Telehealth professionals deliver service from remote locations. Teleradiologists never set foot in a hospital. As store-and-forward practitioners, they interact electronically. Certain aspects of medical histories – critical to consider for onsite physicians – are irrelevant in the absence of physical contact (for example: PPD tests). Further, it is unnecessary for a tele-provider to be schooled and practiced in the onsite procedures each clinic follows to maintain safety at their facility.


Rewriting the rules for credentialing

Medical staff offices are beginning to recognize the need to update bylaws and standards to distinguish between the requirements for onsite and telemedicine professionals. While onsite personnel may still necessitate primary source verification (PSV), much of the burden for authenticating tele-providers may be offloaded to telehealth organizations through credentialing by proxy.

At vRad, our legal counsel often work with clients interested in drafting language into their bylaws that enables them to take advantage of the benefits of credentialing by proxy. They bring with them an understanding of federal standards, as well as varying requirements across all 50 states.

I should note that there are currently three states that do not allow the use of credentialing agreements: Arkansas, Massachusetts and New York. Legislation is pending in Massachusetts, so that door may be opened soon.


What to look for in a telehealth partner agreement

Once your medical staff office is prepared to allow credentialing by proxy, there are some important components to consider before reaching agreement with individual providers.

Who will provide ongoing oversight of the physicians?

The tele-provider must comply with standards comparable to the expectations of your organization. vRad meets or exceeds the standards set forth by the Centers for Medicare & Medicaid Services (CMS) and the Joint Commission, supporting compliance with guidelines at the federal level and within each state.

How will I access the information I need?

You need ready access to individual records for every member of your staff, both onsite and working remotely. The advanced vRad system provides clients complete online access to verification data for each of their teleradiologists, 24 hours a day. Through their client portal they can view detailed verification data, including a license, a profile, or an educational certificate.


How will this fit with our existing processes?

Ideally, the tele-partners’ system integrates seamlessly into your processes without disruption. Flexibility is central to the design of the vRad platform, enabling us to connect with hundreds of hospitals and clinics across all 50 states. We adapt our system to match the needs of individual facilities, from changing verbiage to reflect organizational preferences to expanding or restricting file access based on discrete user criteria.

If your organization is ready to make the move to more efficient, effective credentialing for telemedicine professionals, we’re ready to help. Contact me to discuss your situation. We’ll put our team to work on a plan to address your needs.


About the Author

Author Roberta Monte

Manager of Physician Services. A part time position as a nursing assistant ignited in Roberta a passion for quality healthcare that still burns bright after 20 years. She now oversees the privileging of over 500 vRad teleradiologists serving clients in all 50 states. A native Minnesotan with small-town roots, today she enjoys life in the Twin Cities, with two rambunctious boys, and her husband of 15 years.



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