After a soft launch in April 2013, the Educational Commission for Foreign Medical Graduates’ electronic credentialing verification offering, the Electronic Portfolio of International Credentials (EPIC), is quietly ramping up. And that’s according to plan, says William C. Kelly, MS, associate vice president for operations at ECFMG, based in Philadelphia. Kelly recently spoke with CRC about EPIC, which enables international medical graduates (IMGs) to provide credentials electronically, and lets medical schools verify credentials.
Q: EPIC has been online for about eight months now. Is it working as planned? What kind of feedback have you gotten?
Kelly: We launched after thorough testing (including SCRUM releases every couple of weeks). In April we finally finished what we through was the last little bit. EPIC launched in April, and it was a soft launch. It took couple of years to write the software and we’re confident in the new system.
We’ve made some tweaks based on initial user feedback. Most of what we had to tweak was in the instructions. We have to be accommodating to our applicants with regard to specifications, such as the proper size of photo, uploading of scanned diplomas and transcriptions, etc. We made changes so we could fix everything at our end if an applicant says “this is the diploma,” but it’s really the translation, or “this is my photo,” but it’s really something else. Those were things we worked on to make EPIC more user-friendly.
Q: Who uses EPIC?
Kelly: So far, it’s primarily been used by physicians who have gone through the ECFMG certification process. Many of them are probably interested in doing residence training or licensing in the United States, but not necessarily all. There are a lot more ECFMG-certified physicians than there are programs available. We have a certificate holders program—if a physician establishes an EPIC account, we add all of their primary-source-verified credentials that they had for the ECFMG certification program.
Our primary marketing efforts will be to international medical regulatory authorities, especially countries that don’t primary-source-verify all physicians who are going to their country.
Most countries have a verification system for physicians that train in that country, and there are a number of nations that verify their own IMGs, but may not require primary source verification on all practitioners. In these countries, EPIC can help because medical regulatory authorities just point the physicians to get their credentials verified through EPIC. There’s a real benefit for the regulatory authorities.
That’s the focus now that we’re confident the system is robust.
Q: What other countries’ medical institutions are using EPIC?
Kelly: ECFMG already does credentialing of IMGs who apply to practice in Canada and Australia. So, for example, everybody who’s trained outside Australia and New Zealand who is going to Australia has to have credentials primary-source-verified through us. We have a separate process for both Canada and Australia—they apply to the Medical Council of Canada or the Australian Medical Council, then the council electronically transmits the credentials they want us to verify.
We’re looking to other medical regulatory authorities and opportunities as well. Some do their own verification and some don’t do it all. Primary source verification is a time-consuming and labor-intensive process. We believe we have the expertise, and the organizational and training structure so if they want to start credentialing, ECFMG can do it for them. If they already do their own credentialing, they can delegate it to us.
This is a long-term process. We have the resources to take our time in developing this.
Today’s Monday memo includes a question and answer from our recent webcast “Overcoming Competency Assessment Challenges: All About Advanced Practice Professionals.” If the question sounds familiar, the answer might offer some clarity.
Q: Are the terms “collaborating physician,” “sponsoring physician,” and “supervising physician” interchangeable when it comes to requirements for advanced practice professionals?
A: That depends on your state law and what it defines as a collaborative or supervising situation as well as your own internal definition. Physician assistants are almost always supervised (Alaska allows for a collaborative plan), but nurse practitioners—depending on state statutes and individual hospital requirements—can either be supervised or can practice under a more collaborative arrangement or can practice independently.
I don’t see those terms as interchangeable, although organizations will frequently use them in the same context. Basically, practitioners can’t go hang out a shingle on their own or practice in a hospital setting if the hospital requires some type of a physician sponsor, collaboration, or supervision. Some states require a collaborative agreement, but hospitals might have stricter requirements and require something tighter such as supervision. If the hospital has stricter requirements for advanced practice professionals, “supervising” and “collaborating” may not be interchangeable in that setting.
On the other hand, a “sponsoring physician” could be either the supervising or collaborative physician. It depends on what your state and your organization requires.
— Sally Pelletier, CPMSM, CPSC, Advisory Consultant and the Chief Credentialing Officer, the Greeley Company, Danvers, Mass.
Click here for more information about this webcast or the others in this three-part series.
And as always, thanks for reading!
Mary Stevens, Managing Editor, Credentialing Resource Center
The National Practitioner Data Bank (NPDB) issued a press release earlier this week about the implementation of Section 1921, which expands the practitioner information the data bank collects. More details about the new Section 1921 regulation will be published in the Federal Register within the next five to 10 days.
Nevertheless, the press release revealed that Section 1921 will expand the information contained in the National Practitioner Data Bank (NPDB) to include:
- Adverse licensure actions taken against all licensed healthcare practitioners
- Any negative actions or findings by State licensing agencies, peer review organizations, and private accreditation organizations against all health care practitioners and entities
Anne Mitchell, RN and Vicki Galle, RN, two nurses from West Texas, tried reporting a physician’s problem behavior through designated hospital channels. When their complaints fell on deaf ears, they took the next step and anonymously reported the physician to the Texas Medical Board.
If you’re a follower of Rita Schwab’s Supporting Safer Healthcare blog you already know what happened next – the medical board notified the physician of its investigation. In turn, the physician contacted the local sheriff to file a harassment report. The sheriff’s investigation led to third degree felony charges for the nurses.
Newspaper columnists have also come out in support of the nurses, saying the state’s whistleblower laws should offer more protection.
What do you think of the case? Do you think a similar situation could occur within your medical staff?
Practitioners prescribing medication need to be licensed to practice in the state where they are prescribing, otherwise they could end up in prison like one former Colorado psychiatrist.
Christian Hageseth, a former psychiatrist, prescribed antidepressants after telephone patient consults. One out-of-state patient later committed suicide. Although an investigation found that the antidepressants were not linked to the death, Hareseth was sentenced to nine months in prison for prescribing without an in-state license.
“This really doesn’t have anything to do with telemedicine; it really has to do with following the appropriate protocols in both patient management and license credentialing,” says Dale Alverson, MD, president-elect of the American Telemedicine Association and medical director for the Center for Telehealth at the University of New Mexico Health Sciences told Modern Medicine in a June 5 article. “If you’re going to practice healthcare in another state, whether it’s virtually through telehealth or face to face, you should be duly licensed and credentialed.”
The Medical Board of California revoked Dr. Roy Chi Wing Lung’s medical license after he was found to have repeatedly stolen medical supplies from hospitals to sell on eBay, according to an Orange County Register article.
In 2004, the physician allegedly stole two computers from Long Beach Memorial Medical Center after showing up at the hospital in scrubs in an attempt to blend in.