HOW HISTORICAL DATA CAN BE KEY TO PATIENT SAFETY
Primary Source Verification and Ongoing Monitoring is Essential to Effective Provider Credentialing and Privileging
Sometimes there’s more to the picture.
Thorough screening followed by continuous monitoring as part of the credentialing process is the most essential task in the process of providing quality care and protecting patients.
However, in the past, without instant access to verified data available in a secure cloud, or online, it was nearly impossible to keep up with re-credentialing every two years, let alone monthly or continuous monitoring.
Dr. Death in the News
There is very little question that hospitals and their physician leaders want and need complete information about applicants. While the online sources such as the Office of Inspector General’s List of Excluded Individuals and Entities (OIG’s LEIE) is commonly used, it takes FACIS® plus other primary sources to disclose the type of issue discussed in a 2013 Dallas News article on surgeon Christopher Duntsch, known as Dr. Death, titled “Sex abuse allegations vs. doctor began at Parkland- and kept going” and many similar stories prior to and continuing to this day including the infamous Dr. Death characterized in this DBrief article from 2016 and from ProPublica’s 2018 perspective.
The Dallas News article suggests that the medical profession and health care organizations continue to turn a “blind eye” in some situations. (See the bestseller “Blind Eye” by James B. Stewart if you have not already read it.) There is simply no substitute for good, candid disclosure of problems or even potential problems when providing a reference in response to another institution’s request.
Many attorneys err on the side of caution when advising their clients on disclosing information about a physician with whom they have had an affiliation. However, our system is only as good as we allow it to be. Without candid disclosure, hospitals will continue to place physicians on staff and grant privileges without knowing their complete backgrounds. The organization can Google, call, write, cajole, check and plead with fellow physicians, but for those whose expertise is evasion, they have many tricks up their sleeves including intimidation.
Timing is Everything—Learning of Adverse Actions in time through Ongoing Monitoring can Make the Difference
In the DBrief article, the writer, Matt Goodman states, “But patient advocates and the surgeons that mobilized to rid him of his license say that Duntsch was the perfect storm. Nobody stopped him soon enough. The hospitals didn’t do their due diligence until it was too late, and those who could’ve spoken up didn’t.”
However, had a hospital checked and continuously monitored against FACIS®—the historical through real-time data platform of exclusions, debarments, sanctions, disciplinary actions, and other adverse behavior—they would have found multiple arrests for impaired driving, drug possession charges, and shoplifting that should reflect on the character and competence of a surgeon. They also would have found sanctions and disciplinary actions that never ended with the loss of license or exclusion but tell a tale of warning to a health care delivery organization looking to hire and grant privileges to a back surgeon—the big-ticket revenue generator for a hospital or surgical center.
Laura Beil, a contributor to ProPublica opens her piece on Christopher Duntsch with, “Why did it take so long for the systems that are supposed to police problem doctors to stop him from operating?” She summarizes that while practicing with privileges for back surgery in Dallas, of the 37 patients he operated on, 33 had what is known as “never events” complications, and 2 patients died in the hospital after surgery. She continues, “Multiple layers of safeguards are supposed to protect patients from doctors who are incompetent or dangerous, or to provide them with redress if they are harmed. Duntsch illustrates how easily these defenses can fail, even in egregious cases.”
No Stone Unturned for License Verification
Complete and comprehensive initial credentials screening and verification require that Medical Staff Professionals (MSPs) and physician leaders make use of all available technology when processing a new practitioner’s application. Yet there are many health care delivery organizations that do not tap historical data or records from other jurisdictions and license types than where the applicant currently lives and the type of practice applying for.
While those governing medical affairs at health care delivery organizations and state licensing boards have the responsibility to keep bad actors out of the system or remove them as quickly as possible, there are many important processes and procedures in place that may delay the removal of a dangerous or incompetent provider.
Turn-Key Compliance and Credentialing Solutions are the Answer
The simple act of screening and monitoring against primary sources such as OFAC, DEA, NPI, FBI, OIG, SAM, State Licensing Boards, and Agencies, which are all included in FACIS®, but also the National Sex Offender Registry and State Abuse Registries. Let the data do the work. Verisys provides health systems with actionable documentation, FCRA compliance, and protection.