Vendor Credentialing Implications for Canadian Healthcare



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Vendor Credentialing Implications for Canadian Healthcare John Simmons On behalf of MEDEC Tuesday May 10 th, 2011 ADVANCING HEALTHCARE THROUGH INNOVATIVE TECHNOLOGIES AND DEVICES ASSURER DE MEILLEURS SOINS DE SANTÉ GRÂCE À DES TECHNOLOGIES ET DES DISPOSITIFS INNOVATEURS www.medec.org

What is MEDEC? MEDEC is the national association representing the medical technology industry in Canada The industry is committed to providing safe and innovative medical device technologies that enhance patient care and advance patient outcomes The industry employs over 35,000 Canadians in close to 1,500 corporate facilities and represent nearly $7 Billion in sales per annum The industry is committed to ensuring Canada has a strong and vibrant medical technology industry 2

What is Vendor Credentialing? 3

What is Vendor Credentialing? Policies and practices to manage vendor interactions & access to health care facilities Key focus on medical technology industry representatives (MTIRs) Access to OR & other procedural areas Vendor Credentialing is designed to address concerns about: MTIR training & product knowledge Patient privacy & safety Vaccinations Vendor tracking Controlled access to restricted areas Compliance to contracts 4

So what is the issue?...sign in at Purchasing and get a Visitor s badge 5

So what is the issue? Current Systems Practices vary widely from one hospital to another Often difficult to find written policies Manual processes no tracking Vendor Compliance Third Party Solutions In the U.S. we have seen several third party solutions to address these concerns MTIRs register through third party service Provide required information (can be customized by hospital) No cost to the hospital In Canada we are seeing the emergence of third party solutions to address these concerns 6

So what is the issue? Third Party Solutions can create other issues There is no national credentialing standard Practices still vary widely from one hospital to another Increased cost to the healthcare system Costs to vendors can be significant Privacy concerns for MTIR information Core issue is sometimes blurred by the solution Is it Vendor Credentialing or Vendor Management 7

Overview What is Vendor Credentialing? What issues are we trying to address What options are available? The old school approach Third party solutions The Hospital Perspective Vendor Perspective A case study the US experience An option for a cooperative solution MEDEC s suggested approach Summary 8

Key components of Vendor Credentialing Vendor management Vendor access & tracking Training validation Product / device / procedural training OR training & protocol Blood borne pathogens Health Vaccinations Patient Confidentiality Code of conduct Background verification Hospital policies, procedures & orientation 9

Objectives of Vendor Credentialing Improved patient safety & privacy Compliance to hospital policies Verification of MTIRs training & education Improved quality care & clinical outcomes Improved risk management Compliance to hospital contracts 10

The balance may shift by hospital Vendor Management Vendor Credentialing Product Training Access Policies Tracking Confidentiality 11

Often the focus is on Vendor Management Vendor Management Vendor Credentialing Control Access Tracking Reporting Policies Confidentiality 12

What Options are Available The Old School Approach Third Party Solutions Cooperative Approach Industry Leadership 13

What options are available? Option 1 - The Old School Approach Hospital MTIRs required to sign in at Purchasing Specific policies communicated to MTIRs Vendor Responsible for MTIR training & credentials Compliance to Code of Conduct 14

Option 1 The Old School Approach Pros Simple, easy to administer vendor management No additional cost or complexity Responsibilities with both hospital and vendors Cons Questionable effectiveness & compliance No tracking mechanisms Each facility is unique Can not address credentialing issues limited in scope to confidentiality, policies & procedures Requires continuous effort to maintain 15

Option 2 Third Party Solutions Third party vendor credentialing organizations (VCOs) provide full service offerings to hospitals typically at no charge to the hospital Vendor management Kiosks can print Visitors badges for approved vendors Tracking reports on vendor activity Scheduling tools Credentialing services Criminal background and Immunization Customization of requirements by facility to comply with hospital specific policies Vendor organizations pay an annual fee per representative (sales, service & delivery) Fees are per representative not per facility Fees range from $130 - $250 / rep annually 16

Option 2 Third Party Solutions Third party solutions are widespread in the US In Canada we have at least 2 active companies offering their services to Canadian hospitals At least one Canadian hospital has implemented a third party solution, others are in process 17

Third Party Solutions Why are they attractive to Hospitals? Vendor management Provides control over vendors and MTIRs Reduces occurrence of off contract products entering facility Tracking reports / Scheduling tools Improved patient safety Background checks & immunization history Compliance to hospital policies & procedures (OR, cath lab) Reduced burden of managing old school approach Reduced time & cost of administering unique program & policies No direct cost to healthcare facility 18

Third Party Solutions Why are they concerning to Vendors? No common standard for MTIR credentialing May impose standards not reasonably related to duties performed by vendors Cost & complexity Increased cost to vendors will increase the cost to the Canadian healthcare system Requires vendor resources to manage credentialing processes Privacy of MTIR information Potential duplication of existing training, controls & screening processes Inconsistency with contractual obligations 19

US Case Study ADVANCING HEALTHCARE THROUGH INNOVATIVE TECHNOLOGIES AND DEVICES ASSURER DE MEILLEURS SOINS DE SANTÉ GRÂCE À DES TECHNOLOGIES ET DES DISPOSITIFS INNOVATEURS www.medec.org

US Vendor Credentialing - Background Historically vendor management & credentialing mirrored the current environment in Canada Mix of Old School approaches existed Mid 2000 s a few converging forces Liability concerns about MTIR product training Increased focus on infection control Increasing requirement for rep access fees Accreditation concerns Rapid emergence of third party solutions to address these concerns Fragmented approaches Significant cost & complexity concerns from vendor community Challenge defining what vendors need credentialing 21

US Vendor Credentialing Current Situation Significant consolidation of third party vendors No unifying national standard Each hospital or system are unique Remains focused on vendor management & access Concerns on immunizations & background checks are overblown No processes have been implemented to address these concerns with hospital visitors who far outweigh the number of MTIRs Still a contentious issue Lack of communication between hospitals & vendors Increased cost & complexity for vendor community Resources required to manage credentialing requirements Concerns remain about MTIR privacy 22

US Vendor Credentialing Key Concerns Privacy Concerns for MTIR personal information Vendor community not satisfied that third parties can safeguard this adequately Lack of unifying credentialing standard Every hospital or group is unique Cost & Time Registration costs can be significant Administrative costs to vendor community Costs are flowing back into healthcare system Delays in the introduction of new technology Limits access to new technology Vendor credentialing systems are potentially burdensome to smaller vendor organizations 23

Option 3 Cooperative Approach through Industry Leadership ADVANCING HEALTHCARE THROUGH INNOVATIVE TECHNOLOGIES AND DEVICES ASSURER DE MEILLEURS SOINS DE SANTÉ GRÂCE À DES TECHNOLOGIES ET DES DISPOSITIFS INNOVATEURS www.medec.org

MEDEC Position Paper 25

MEDEC Position MEDEC fully supports the concept of assuring credentialing Must find an efficient approach without duplication, additional cost or risk to employee privacy Support the creation of common national standards Until national standards are in place credentialing practices should reside with the vendor companies Ensure compliance through corporate attestation to mandatory yet reasonable criteria MEDEC will seek to create a forum to develop common standards and efficient practices for compliance 26

Option 3 - Cooperative Approach Opportunity to develop unifying National Credentialing Standards Consistent credentialing standards to serve as the overarching framework for vendor credentialing in Canada MTIR training (product, privacy, hospital conduct) Employer background checks MTIR immunization Patient confidentiality Code of conduct Hospital policies and procedures MEDEC is prepared to champion this process in cooperation with hospitals and aligned associations MEDEC resources and an industry taskforce have initiated this process 27

Summary Current old school approach to vendor credentialing is sub-optimal There is a clear opportunity to define & improve sound practical requirements for MTIR credentialing with a goal to: improve quality care protect patient safety and privacy respect health care organization policies MEDEC advocates a cooperative approach and is committed to creating a forum for the purpose of developing common national standards 28

Thank you! For more information, please contact: Maarten Billen, Manager, Member Services MEDEC 405 The West Mall, Suite 900 Toronto, ON M9C 5J1 phone: 416.641.2754 mbillen@medec.org www.medec.org ADVANCING HEALTHCARE THROUGH INNOVATIVE TECHNOLOGIES AND DEVICES ASSURER DE MEILLEURS SOINS DE SANTÉ GRÂCE À DES TECHNOLOGIES ET DES DISPOSITIFS INNOVATEURS www.medec.org