Web repository solves physician credential verification woes

Moving physician credentialing information to an online database has streamlined credential-based approvals and improved patient care at one institution, according to a paper presented Sunday at the Healthcare Information and Management Systems Society meeting in Atlanta.

"We can now verify the privileges of any caregiver in the University of Alabama at Birmingham (UAB) Health System, in any setting," said Dr. Scott. E. Buchalter, chief of staff.

Prior to implementation of the online system, credentials could be checked only when the staff office was open, usually Monday through Friday, 8 a.m. to 5 p.m. The diverse set of forms that each service evolved over the years could make interpretation of privileges difficult to determine. Sixteen distinctly different types of medical credentials were identified, each one maintained by someone outside the staff office. Privileges varied from form to form.

"The privilege to suture lacerations might appear as 'lacerations, suture' on one form, 'suture minor lacerations' on another, and 'lacerations, suture of minor' on a third," Buchalter said.

The new repository, which is available on the hospital intranet, standardizes the wording and allows UAB to perform the sometimes sensitive credential check easily, rapidly, and inconspicuously at any time.

Phone calls to the staff office have dropped from about 250 a year to under 50. Because the staff no longer uses binders to look up privileges, time of verification is reduced from 30 minutes or more to only a few seconds.

The repository was created using an industry standard relational database. It contains information on 1028 caregivers with 2277 privileges, representing 16 services (medical, surgical, dental) divided into 38 classes of privileges (low-risk, high-risk) and 130 types of privileges (internal medicine, allergies), Buchalter said.

The availability of this information opens the door for innovative new uses of the data, including the notion of using the database to perform service-specific searches for medical personnel with a specific privilege.

"The repository could be used to find someone who can insert a pacemaker or someone who can salvage organs," Buchalter said.

The online system could even be integrated with a physician sign-in/sign-out feature, which would help find an in-house physician with a specific privilege, potentially saving time in critical situations.

The staff office now views the system as mission critical. During 2001, they updated privileges in the database an average of 288 times a month. In the month of June alone, when new doctors come on board at the university, privileges were updated 2290 times - an indication of how many times paperwork in the old system had to be redone each year, according to Buchalter.

"It also reflects the up-to-the-second accuracy of the data now, something that was impossible to do under the paper-based system," he said.