Earlier this month, medical services professionals (MSPs) gathered at the Long Beach Convention Center in California for the 42nd National Association Medical Staff Services (NAMSS) Educational Conference and Exhibition. The 2018 conference theme, “Innovation for Patient Safety,” not only reflects the constant forces driving change in the healthcare industry, but also the medical services profession’s ongoing commitment to patient safety. With the changes facing the industry, MSPs must continue to embrace innovation in order to part ways with tradition and thrive in the new environment of tomorrow.

The following represent my top three takeaways from this year’s NAMSS conference.

Expanding Oversight Beyond the Walls of the Hospital

With patient volumes shifting to the ambulatory care setting, the traditional hospital setting for MSPs is becoming a thing of the past. “One of the biggest changes taking place in healthcare is the evolution of hospitals from building-centric entities to something very different,” according to Dr. Todd Sagin, President and Medical Director at Sagin Healthcare Consulting. “Hospitals are morphing into ‘Integrated Delivery Systems’ encompassing increasingly more community healthcare assets.”

With the emergence of community assets, the evolving healthcare landscape represents an opportunity for the organized medical staff, which was put in place specifically to provide oversight to the care within the walls of the hospital. With a significant portion of practitioners conducting most of their work in offices, medical staff services should consider establishing an ambulatory care department to provide oversight to their quality. “Regulators, politicians, and the public are going to turn to healthcare institutions to question what they are doing to monitor the care on an outpatient basis,” Sagin explained during his session on the topic.

The Rise of Medical Staff Systematization

The healthcare landscape has always been complex, but hospitals and other healthcare organizations are being tasked to deliver better, more efficient care with fewer resources in today’s environment. With roughly two-thirds of America’s community hospitals being part of a system, the high percentage will continue to grow as long as mergers and acquisitions are common in the industry.

Within a system, medical staffs can be categorized in three key categories:

• Independent: all hospitals and medical staffs are essentially independent;
• Standardized: individual hospital medical staffs and hospitals working under the same rubric; and
• Unified: a technical definition established by CMS in 2014 to allow a hospital system to have a single medical staff.

While medical staff unification has many benefits, it may not work for every hospital or hospital system. In a conference session titled, “From Independent to Unified,” Elizabeth Snelson, Legal Counsel for the Medical Staff PLLC, warned MSPs about moving to unification without carefully considering its many implications for the medical staff.

“Sometimes the medical staff connection with the governing body is broken if you have a system that doesn’t include the medical staff out there taking care of patients,” Snelson explained. “Systematization can provide many of the benefits of unification without eliminating local control. Systamitzation is an option that more hospitals are going to, but you have to proceed with caution especially with medical bylaws and credentials.”

The Emergence and Prevalence of Telehealth

“You can take almost any healthcare specialty and put tele- in front of it,” Sally Pelletier, Advisory Consultant and Chief Credentialing Officer at The Greeley Company, stated during a breakout session. “Telehealth is not going to go away. Every day you can read about how a healthcare organization is embracing it.”

Healthcare organizations have options for credentialing and privileging a telehealth provider. In 2011, CMS gave organizations the power of choice where they could have a full process similar to a standard practitioner, or they could rely on the credentialing and privileging decision of a medicare participating hospital or a distant site telemedicine entity (DSTE). Additionally, NAMSS and the American Telemedicine Association (ATA) have partnered together on the Credentialing by Proxy (CBP) initiative. “There is no one-size-fits-all,” Pelletier cautioned. “For accreditation, the Joint Commission, DNV GL, HFAP, and CIHQ followed suite with revised telemedicine standards.”

Frances Ponsioen, Consultant and Senior Director of the Credence Business Unit at The Greeley Company, explained a few considerations for credentialing in telemedicine. “Make sure that your bylaws identify all three credentialing options for telemedicine providers, and then determine based on the applicants that you have, which one you should apply and ensure that you have followed the appropriate process to protect the patients.”

Depending on state laws, regulators, and accreditors, MSPs need to ensure that agreements have all the necessary language related to all applicable standards. “There are also standards with relation to contacts,” Ponsioen explained. “Make sure you have that information in writing and address the DSTE CMS requirement. That distant siste must meet the requirements.”

In order to address the ongoing changes affecting the healthcare industry, MSPs need to embrace innovation. The emergence of the ambulatory care setting, medical staff systematization, and the prevalence of telehealth all represent opportunities to optimize processes and improve patient safety in the changing landscape.

Did you attend this year’s NAMSS conference? Please share your favorite takeaways in the comments section below.