The Healthcare Industry falls into the spotlight of non-compliance again as the GAO raises red flags on the credentialing and privileging systems of the Department of Veterans Affairs for doctors.

The results of a VA investigatory report in 2008 of the Marion, Illinois, VA medical center (VAMC) revealed patient deaths exceeding expectations four times between October 2006 and March 2007.  Wanting to further their research in attempts to pinpoint reasons for the results, the GAO launched this research study.

In particular, the credentialing and privileging processes, as well as the continuous monitoring of physician performance, went under the knife (please excuse the pun).  Six VAMCs were selected for scrutiny and 180 credentialing and privileging files were reviewed.  GAO selected files based on various physician characteristics including highly paid specialties and newly hired physicians. 

Although the results did not mirror the original findings from the VAMC in Marion, Illinois, take a look at these shocking findings:

• “29 of the 180…files reviewed lacked proper verification of state medical licensure.”
• “GAO identified 21 files where required malpractice information was not disclosed by physicians and was not detected by VAMCs.”

I am no statistician, but both of these findings show that between 1 and 2 files out of every 10 physicians hired showed major deficiencies in the credentialing department!  The GAO even stated that the malpractice information overlooked (when not shared by the physician on the applicant – which don’t get me started on non-disclosure of pertinent information demonstrating lack of character in the first place) shows up on an external database the VAMCs should already be reviewing!

So what were their conclusions? The title of the GAO’s report gives this away – “Improved Oversight and Compliance Needed for Physician Credentialing and Privileging Processes.” 

I don’t want to get on a soap box, but there are some great medical credentialing software available that make credential management a walk in the park.  Amistaff’s BlueSky Medical Staffing Software paired with NurseTesting’s Validated Competency Exams make a dynamic duo to overhaul, and drastically improve, the Department of VA’s credentialing and privileging processes. 

For more information on this topic – view the GAO’s full write-up.