Industry Voices—Telemedicine's time to shine: Can credentialing keep up?

Older patient using telehealth
Medical credentialing needs to keep pace with the adoption of telehealth. Real-time primary-sourced data can be centralized and automated, making provider verification across multiple states easier, quicker, and more accurate. (Agenturfotografin/Shutterstock)

Hospitals closing in remote areas, physician shortages, limited access to specialists and other care providers—all reasons we were already seeing an increasing number of Americans turning to telemedicine options for medical care.

Now, the coronavirus pandemic has propelled the value of telemedicine to center stage. The House passed a coronavirus emergency response bill allocating approximately $500 million to Medicare reimbursement for care providers using telehealth to treat seniors from home.

Last week the Federation of State Medical Boards (FSMB) offered assistance to help expedite verifying licenses and credentials of providers and other healthcare professionals who wish to practice across state lines.

According to the American Medical Association, telemedicine is growing fast, having increased 53% from 2016 to 2017, and the market is expected to hit $130 billion by 2025.

One survey found that physician telehealth adoption is up 340% from 2015 when only 5% of physicians reported having ever used telemedicine. The Monday through Friday, 9-to-5 model of care that happens within the four walls of a clinician’s office was no longer working for the majority of people even before the COVID virus arrived.

RELATED: 3 keys for physicians to keep their medical practice running in the time of coronavirus

Telemedicine, also known as telehealth, mHealth, e-health, telemed, or mobile health, is vital for the future of medicine, particularly given the challenges we face in healthcare today. But can credentialing keep up?

We know coronavirus is driving demand for telemedicine; it’s crucial that providers are credentialed to handle the spike. If a physician isn’t properly credentialed, practicing medicine anywhere (let alone across the country) and getting paid, is virtually impossible.

Physician credentialing is complex, and we’ve talked about the challenges associated with maintaining providers’ licenses many times. However, as hard as it is to credential a physician who practices in a clinic or a locum tenens who rotates frequently, telemedicine presents a whole new set of roadblocks for the credentialing world.

Ignoring the credentialing puzzle for telemedicine will only slow down the momentum we’re seeing and negatively impact care for the patients who rely on it, especially during times of crisis.

Where are the challenges?

The benefit of telemedicine is the flexibility it provides patients, especially those with limited access to care, even more so with the COVID-19 crisis and the need to keep in-person interactions to a minimum.

The key: Doctors need to be licensed in the state they are providing that care. So if a doctor licensed in California is treating a patient in Kansas, the doctor also needs to be credentialed in Kansas. That same doctor may see a patient remotely in Wisconsin but—you guessed it—she also needs to be credentialed in Wisconsin.

However, doctors having and maintaining credentials in multiple states is quite the anomaly, partly because before telemedicine, doctors didn’t need to retain multiple licenses. Technology has changed that.

RELATED: Dispatch from a country doctor: Seeing patients differently in the time of coronavirus.

CNBC reported on research showing that as of 2018 there were only 14 doctors licensed in every state across the country. In 2016, it was a mere six. But with telemedicine still seeing an upward trend and potential pressure for regulatory change, that number is expected to grow.

There are unique challenges to physicians being credentialed in more than one state, however. For starters, the process of getting credentialed has historically been very expensive—when you add in the cost for credentialing in multiple states, the cost starts to rack up.

For example, a medical practice can spend more than $7,000 a year on each physician’s credentialing application—for one state. It can also be very time-consuming; administrators spend 20 hours to credential every provider, and it can still take two to three months before a new doctor can start working.

Finally, there isn’t a lot of understanding surrounding the process of credentialing for telemedicine, which can be a huge deterrent, mainly due to unique individual state mandates.

Despite these obstacles to physician credentialing, there is a growing understanding that telemedicine is important for the future of healthcare, especially in the face of a pandemic. Though credentialing is a puzzle for telemedicine, the time and resources needed to figure it out are worth it for the patients who could greatly benefit from its advantages.

This complicated process begs the question: How can we remove these major barriers and make it easier for doctors to offer telemedicine services?

It’s time to modernize telemedicine credentialing

The process the majority of practices use to keep their physicians licensed is grossly outdated. Whether you’re looking at credentialing for telemedicine or for a physician practicing in one state within the four walls of a clinic, it’s clear that there’s a need for the credentialing process to be simplified.

Telemedicine has been around over a decade, and the pace is picking up—yet how to effectively credential for telemedicine remains uncharted territory.

RELATED: As COVID-19 isolates patients, telehealth becomes lifeline for behavioral health

There are resources that make it easier for physicians to get licensed in multiple states—for example, the Interstate Medical Licensure Compact. Even so, maintaining licenses is just as key and often where things tend to fall through the cracks, leading to late fees and gaps in care due to expired licenses.

Organizations that continue to rely on Excel spreadsheets to credential physicians who practice telemedicine (or any kind of medicine) will stay on the hamster wheel. Heaps and heaps of paper aren’t manageable in spreadsheets.

New breeds of cloud-based credentialing technology exist now and can improve this process, helping to move adoption forward. Real-time primary-sourced data can be centralized and automated, making provider verification across multiple states easier, quicker, more accurate, and more secure.  

We need to develop a standard across the board. We need to ensure that patients are talking with high-quality, licensed physicians. We need to ensure that every provider is being held to the same standards.

Modernizing the credentialing process will make it easier for talented, fully credentialed physicians to more seamlessly see patients whenever and wherever care is needed and in a way that’s most convenient for both patient and provider.

Telemedicine use is already growing, and healthcare epidemics like coronavirus will continue to drive adoption.

Let’s give providers the tools they need to help more patients. Let’s empower providers to practice remotely and remove the endless list of obstacles deterring them. The end result: Patients have access to the care they need, whenever and wherever they need it.

John Bou is the COO and co-founder of Modio Health. Modio is a physician-owned and operated platform making credentialing and career management simple, transparent, and efficient for healthcare professionals.

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