Over the years here at Children’s Medical Center in Dallas, we have worked to streamline our credentialing processes as much as possible. Most of this is done through utilizing technology. We have implemented online physician orientation modules at initial and reappointment. WE have electronic OPPE data profiles that the division chiefs can log in and review electronically as well as drill down on quality indicators to get more specific data. FPPE is also electronic; it is linked to our electronic medical record system so proctors are notified electronically that there are cases for them to review and they can they complete the chart audit electronically. Through the use of laptops, we’ve had paperless medical staff meetings for many years.
We recently started the transition from using our old laptops in all of our medical staff meetings to incorporating iPad ©tablets. I asked our director of medical staff services, Kenneth Enad to give me a quick summary from his perspective on this new initiative. His words are worth sharing with others debating whether to go paperless:
“Preparing the packet for the credentials committee meeting has come a long way over the past few years. The entire team used to spend more than a full day gathering material for the packets and literally running around making copies to the point where it was an approved sneaker day. The environment would be such high stress, and I can’t even begin to count the number of times the copy machine would break!
I would say our transition from killing so many trees depended on two major steps. First, we developed an organized process to collect the material for the packet. We structured our shared network drive with a folder created for each major category (new applicants, additional privileges, reappointments, etc). Firm deadlines for each coordinator for getting the information into the folders gave the parameters necessary to allow all five MSPs to contribute to the packet without creating chaos. Secondly, using the Adobe © software and laptops, we found a viable technological solution to gather, merge, bookmark, and display the electronic packets. The committees found these very easy to navigate.
We’re now transitioning to the use of iPads for our meetings. We have found that these are far more cost effective than laptops, and a lot faster to “boot up” before a meeting. So far, the committee members have been very receptive to them. If they’ve never used an iPad © or the iBooks © app before, I give them a 30-second tutorial, and soon enough I see a smile on their face as they impressively tap, pinch, and swipe through the pages of the packet!”
While at the 35th annual NAMSS conference a few weeks ago, I sat in on a discussion about OPPE and FPPE; specifically about how to get the most beneficial usage from these two tools with limited resources. The session presented by Jonathan Burroughs, MD, MBA, FACPE, and Mary Baker, DHA, CPMSM, served as a reminder that OPPE and FPPPE were established to help organizations, not hinder their credentialing and privileging processes. When times are tough and resources are limited, we have a tendency to get bogged down by all of the things we have to do and forget the significance of why we are doing them. Burroughs and Baker shed light on the importance of OPPE and FPPE while also offering some useful tips on how to make these processes more efficient.
In discussing OPPE, Burroughs recommended choosing indicators that measure important aspects of each performance dimension. These indicators can and should change. As new indicators are added into the mix, retire the ones that are not as useful. Burroughs suggested asking each department for one or two things they would like to see improved in the indicator selection process, then trying out those recommendations for a year or two before deciding whether to add them as a requirement for reappointment.
As for FPPE, Baker suggested that FPPE should not be a one size fit all process. Practitioners who bring similar experience and/or practice patterns can be treated in a similar way. The Joint Commission allows for flexibility in FPPE, which should be taken advantage of. “You have the ability to stop, shorten, or prolong FPPE,” said Baker during her talk. For example, if a practitioner’s competence can be evaluated in three or four shifts (an ED physician for example) there is no need to perform FPPE for three to six months. Because concurrent proctoring is time consuming, Baker recommended only using it when necessary. Another way to capitalize on FPPE is to take advantage of technology. Teleproctoring, simulation, and procedure recording are all becoming more popular as acceptable forms of measuring competency. Technology is being utilized for efficiency and patient safety all over the rest of the hospital, so why not in the medical staff office as well?
We’d love to hear from you: Do you use technology to make OPPE/FPPE easier? If so, email me at firstname.lastname@example.org.
A group of scientists at the FDA claiming their managers pressured them to approve some medical devices despite their concerns are having their complaints reexamined, according to a September 30, Wall Street Journal article.
Earlier this year, the Department of Health and Human Services dismissed the allegations of criminal charges against the managers. Now the matter is being reinvestigated as potential administration violations by the managers.
This month’s LocumLife magazine features the article, “Cyber security for locum tenens providers.” It provides great advice for locum tenens and anyone else who relies on modern technology to do their jobs.
Here are some useful tips that your medical staff can benefit from, too:
- Choose strong passwords
- Log-on to secure wireless systems
- Periodically review a computer’s privacy settings
- Keep most of your files on a stationary machine, rather than a mobile device that may get lost in transit
It may be time for your technology assessment committee to revisit the risks and benefits of CT scans. These popular scans were the focus of a recent New England Journal of Medicine article that warned of long-term cancer risks and potential radiation overdoses, according to a June 23 Los Angeles Times article.
Some say practitioners use the scans too often because they are pressured by patients to order them, or because fear of malpractice lawsuits leads to over testing.
However, one of the biggest risks to patients is that the radiation dose in CT equipment can vary widely from hospital to hospital.
Does your technology assessment committee evaluate existing technologies or only proposed technology changes? Share your experiences in the comment boxes below.
Looking for more information about CMS’s new telemedicine credentialing guidelines? Need to educate a credentials committee about telemedicine?
Check out the Center for Telehealth and E-Health Law website: www.telehealthlawcenter.org
If you know of other helpful telemedicine resources to share with your peers, feel free to list them in the comment boxes below.
Most surgeons who perform robotic-assisted surgeries using the da Vinci™ robotic surgical system, or a similar product, learn by shadowing colleagues. Now, the new Robotic Surgical Simulator, or RoSS, allows surgeons to learn through simulation, according to a February 25, SUNY Buffalo press release.
Researchers are calling RoSS a flight simulator for surgeons because it follows a similar method that pilots use. The need for a training simulator was clear in the minds of its creators.
“Hospitals don’t invest in these multi-million-dollar robotic surgery systems so that people can train on them,” says John Burgess, Simulated Surgical Systems, LLC, chief executive officer. “Their most pressing need has been a good training environment for robotic surgery.”
RoSS was created through collaborations between the Center for Robotic Surgery at Roswell Park Cancer Institute (RPCI) and the University at Buffalo’s School of Engineering and Applied Sciences. At right is a photo of creators Thenkurussi Kesavadas from the University at Buffalo and Khurshid Guru of RPCI.
If you’re searching for information to keep your medical device review committees on top of the latest industry news, check out this audio clip from Health Leaders Media.
John Bardis, CEO of MedAssets, a healthcare supply chain and revenue cycle management company, discusses his crusade against the lack of transparency in durable medical devices. This type of financial information is important to keep in mind if your medical staff is considering purchasing new equipment or expanding clinical privileges to include new devices.
Free Live Demonstration
Wednesday, October 7, 2009
7:00 to 8:30 a.m. PST
NAMSS Annual Conference in Reno, NV
Grand Sierra Resort and Casino
Nevada 6 and 7 rooms