Healthcare facilities rely on credentialing companies
Outside firms ensures sales reps are ready for OR
(Editor’s note: This is the second part of a two-part series on sales reps in the OR. This month, we discuss how to use an outside company to credential sales reps and how to inform patients that reps will be in the OR. Last month we gave you an overview of how outpatient surgery providers are addressing the issue.)
Most hospital systems are using an outside credentialing company to verify that the vendor is safe to allow on-site and in certain situations, such as surgery, says Dan Flynn, a surgical instrument sales representative with K&D Medical in Columbus, OH. The hospitals are turning to these outside companies to do all the verification, which frees them of that administrative burden but still gives them assurance that the vendor has been properly vetted.
To be credentialed by these companies, the salespeople and other vendors often are required to complete courses in specific areas of study, such as infection control. Two of the most prominent companies offering vendor credentialing are C in Flower Mound, TX, which provides the Reptrax vendor credentialing service, and Vendormate in Atlanta.
Relying on those companies can be a practical solution, Hoffman says, because the third party might do a more thorough job of checking the person’s background and training him or her than the healthcare facility would. However, she points out that handing the responsibility over to a third party works only if you know that party’s stamp of approval is meaningful. To find out, delve into exactly what the company requires and how it trains people.
"When they say training, do they mean a five-minute video or something more substantive?" Hoffman says. "You have to know exactly what it means when they say someone is credentialed."
Companies offer free services
Reptrax and Vendormate services are provided to facilities at no cost, with the salesperson or the employer paying for the credentialing, explain Greg Goyne, vice president of marketing at IntelliCentrics, and Gary Johnson, chief marketing officer at Vendormate. About 5,000 facilities in the United States use the Reptrax system, with about 400,000 vendors credentialed. Vendormate has about 1,900 facilities using its system and 63,000 companies credentialed. The services can credential individuals and companies.
"The hospital has a way of verifying credentials that is more complete and more efficient than trying to collect paperwork from each visitor," Goyne says. "If The Joint Commission audits you, the credentials are available right away."
The credentialing companies can help a facility achieve the level of scrutiny that most managers say they want of vendors, but which can be too much work for the staff, Johnson says. "We see our job as making that process work as easily and effectively as we can for both parties, the healthcare provider and the vendor," Johnson says.
From a salesperson’s perspective, the vendor credentialing can be a valuable service, Flynn says. He cautions managers, however, not to depend entirely on the word of an outside company when vetting a salesperson or other vendor.
"The credentialing they offer is trustworthy, but remember that they’re also in the business of making money by requiring coursework and giving us the blessing that we need to get in the hospital and do our jobs," Flynn says. "The documentation shows that you took the courses, but it doesn’t necessarily show that you understand what goes on in the OR and how to conduct yourself. That comes from experience."
What the services offer
Facilities that designate Reptrax as their credentialing service can determine what qualifications they require for salespeople or other vendors, and then the service will take responsibility for verifying that those standards are met, Goyne says.
Reptrax and Vendormate keep on file all the records showing the person’s credentials. Those records might include training courses completed, immunizations, criminal background checks, and whether the person is on any healthcare-related watch lists for exclusion related to fraud. Both companies check for updates to the exclusion lists every month.
Once the vendor is credentialed by one of the companies, that information is available to all facilities that use that company for verification. The vendor only has to provide the credentials once rather than doing it for each facility visited. Information is updated in real time, but it is posted in the system only after an employee of the verification company has seen the document and confirmed it is legitimate.
When a facility decides to use one of the companies, it makes credentialing by that company a requirement for access to the facility. Both companies provide kiosks in the facility where salespeople and other vendors can check in and print a document showing they are approved by the credentialing company. The kiosks can print identification badges denoting what area of the facility the person is allowed to visit. "If the person tries to check in, and the credentials do not meet the requirements of this hospital, access will be denied and an alert will be sent to an administrator," Goyne says.
The healthcare facility can drive the credentialing process, Johnson says. By declaring that all vendors must be credentialed and have a badge for each visit, the vendors will respond by seeking the proper credentialing from the company specified, he says. The key, however, is that the staff must enforce the facility’s own policies regarding vendors on site.
"If the OR staff says this is a salesperson who’s been here every Tuesday for five years and we know him, so it’s OK if he doesn’t have a badge, everything falls apart. That can be the weak point," Johnson says. "You need to push for 100% compliance for any non-employee walking your hallways." (For information on how to inform patients, see story, below.)
- Greg Goyne, Vice President of Marketing, IntelliCentrics, Flower Mound, TX. Telephone: (972) 316-6523. Email: [email protected].
- Gary Johnson, Chief Marketing Officer, Vendormate, Atlanta. Telephone: (404) 949-3402. Email: [email protected].
Inform patients: Sales rep might be in the OR
In addition to concerns over patient safety when salespeople are allowed in the OR, managers should consider requiring that patients be notified of the person’s presence, says Sharona Hoffman, JD, professor of law and bioethics, Edgar A. Hahn professor of jurisprudence, and co-director of the Law-Medicine Center at Case Western Reserve University School of Law in Cleveland, OH.
"I think most patients would be pretty surprised to learn that there were people in the OR who were not doctors or nurses," she says. "It would be prudent to include that in the informed consent documents, and that would have to include giving the patient the opportunity to say no, to opt out of having outsiders in the OR during the procedure."
Informing the patient is not required by law, and some would argue that it’s not even necessary in terms of ethical concerns. However, Hoffman says facilities take a significant risk by allowing vendors in the OR without telling the patient. If the salesperson somehow contributed to an adverse event — by compromising a sterile field, for example, or distracting the surgeon — the facility could be accused of negligence for allowing that person in the room. That liability is especially the case if the facility could not prove that it adequately vetted the vendor.
Also, a plaintiff’s attorney could make much of the revelation that a salesperson was present even if the vendor had nothing to do with the adverse outcome or even if the procedure went well, Hoffman says.
"Patients could just be upset that there are people there who are not directly involved in their medical care," she says. "This is the kind of issue that can lead to lot of ill will, bad publicity, once the patient makes his or her dissatisfaction public. The patient may have no damages and no real lawsuit to pursue, but you could still suffer bad press from allegations that you did not respect the patient’s privacy."
