1. Statewide Centralized Telehealth Credentialing
Cheryl Coble, RN, MSN, MHM Director, Physician System Integration Palmetto Health
Victoria Gooch Manager, Telepsychiatry Operations and Billing SC Department of Mental Health
Telehealth Summit 2018

2. Objective
Develop a process for coordinating and streamlining credentialing, with a focus on the needs of hospitals receiving services from multiple institutions.

3. Proposal
Palmetto Care Connections (PCC), will act as an expert and advocate for streamlined telehealth credentialing; whereby a central database will be created and made available to spoke hospitals receiving telehealth services from one or more of the Telehealth Hubs via a By Proxy contract.
Hub Hospitals
Greenville Health System (GHS)
McLeod Health
Palmetto Health (PH)
Medical University of South Carolina (MUSC)
South Carolina Department of Mental Health (SCDMH)

4. The Challenge
For many small rural hospitals, credentialing is challenge due to insufficient staff
Providers must complete a credentialing application for each facility at which they provide telehealth services

5. The Challenge (cont’d)
Example – SCDMH: Each psychiatrist must be credentialed at current 24 hospitals, with several additional hospitals in the near future. The majority of applications are completed by hand, a few are online, and two are by proxy with Bryan Psychiatric Hospital.

6. Timeline – Year One
Advocate for centralized credentialing throughout the state and evaluate current state of telehealth credentialing.
Met with all Telehealth Hubs and addressed need/desire for a centralized statewide model and address credentialing barriers.
Created a Statewide Credentialing Workgroup to discuss and design centralized model.
Developed standard forms and processes.

7. Timeline – Year One (cont’d)
Surveyed SC hospitals on interest in participating in project and potential barriers to a central model.
Presented plans to the South Carolina Association of Medical Staff Services (SCAMSS).

8. SCAMMS Hospital Survey Fall - 2016
60%
Hospitals that need more information on by proxy.
50%
Hospitals currently accepting By Proxy credentialing.
Hospitals would like physician profile/access to physicians file.
34%
Hospitals comfortable with By Proxy arrangements.
31%
Hospitals comfortable with central entity concept.
30%
Hospitals reporting that the governing bodies would be comfortable with By Proxy agreements.
Hospitals interested in hybrid model.

9. SCAMMS Hospital Survey (cont’d) Fall - 2016
Hospital also reported that they’d like to receive the following types of quality data:
Procedure volumes and types
Physician evaluations
Adverse outcomes
Patient complaints against doctor
Co-worker complaints against doctor

10. SCTA agreed to fund project.
Timeline – Year Two
Submitted Credentialing Workgroup Plan to South Carolina Telehealth Alliance (SCTA) for funding. Key elements:
Broad communication of goals and plans to stakeholders.
Joint Commission by proxy method as most feasible option.
Creation of neutral central database to house statewide telehealth credentialing information.
12 month pilot project with MUSC and SCDMH using the central database.
SCTA agreed to fund project.

11. Design of Model User Experience
Spoke hospital identifies need for telehealth provider
Spoke hospital contacts PCC
PCC initiates By Proxy agreement between spoke and Hub hospital
PCC uploads Hub physician data to credentialing database (Cloud based)
Spoke hospital given direct access to provider-specific data

12. Timeline – Year Three Current Year
Hire Credentialing Coordinator
Visit spoke hospitals
Educate on by proxy process and contracts
Work with Credentialing Workgroup to ensure goals are met
Engage a credentialing vendor
ECHO, a HealthStream Company, has been contracted for the Pilot
MUSC contract signed, SCDMH proposal pending
Implement a year long Pilot Program with MUSC and SCDMH

13. Timeline – Year Three (cont’d) Current Year
ECHO will provide the following services:
Assign a Project Coordinator to lead Pilot
Database configuration development via weekly WebEx meetings
Sub-Committee attending meetings include MUSC, PCC, and SCDMH
Database estimated to go live in mid-June 2018 with MUSC, SCDMH go live tbd
Credentialing Workgroup will reconvene in early May to review the database design and pilot progress

14. Timeline – Years Four and Five
Year 4: Expand database to include telehealth providers from Hub hospitals: GHS, McLeod, and PH.
Year 5: Expand to other sub-hub hospitals

15. Summary of Accomplishments
South Carolina Hospitals completed centralized credentialing surveys
Hubs agreed on a centralized telehealth model using the by proxy model and creating a central database
MUSC and DMH agreed to participate in 12 month Pilot Project as they currently provide the majority of telehealth services in South Carolina

16. Summary of Accomplishments (cont’d)
Palmetto Care Connections (PCC) will serve as the lead neutral entity and administrator of the newly created central database
Central Credentialing Coordinator hired by PCC with SCTA funds to oversee the Project
ECHO selected as the central database software vendor HealthStream, ECHO’s parent company, is currently working with MUSC, PCC, and SCDMH to create a custom and comprehensive cloud environment

17. Thank you ! Special Thanks
Thanks to PCC for putting Workgroup together and having the vision for a Statewide Centralized Credentialing Program.
Thanks to SCTA for including this project in the Statewide Telehealth Strategic Plan and funding the pilot program.
Thanks to all of our Telehealth Hubs (GHS, McLeod, MUSC, PH, and SCDMH) for all of their hard work and dedication over last 2.5 years, working together to create a single vision for all of South Carolina.
Thank you !

18. Centralized Credentialing is unique to other states and can easily serve as a model across the country.

19. Please contact PCC for further information or questions:
Kathy Schwarting, MHA
Executive Director of PCC Co-Chair of SCTA Advisory Council (803) OR
Bonnie Church
Credentialing Coordinator (803)