Credentialing is a complicated but rarely discussed problem for doctors, health systems, and health plans. When a doctor wants to start a new job or enter a new payer’s network, their prospective hirer needs to gather a wide variety of certificates and credentials, a process that can take months or even a year.
Anthony Begando, CEO of the Professional Credentials Exchange (ProCredEx), is looking to solve that problem through a network approach that leverages blockchain to verify the credentials. He’ll be speaking about the exchange at HIMSS19 in Orlando.
“On average, as a point of reference, from the time an organization says ‘We’d like to work with Dr. Smith, let’s sign a contract with him and start a credentialing process’ to the point where that person is fully onboarded and enrolled with the payer contracts that organization has and is delivering care can be easily four to six months, if not longer,” Begando said. “We were able to shrink that credentialing lifecycle to 18 to 21 days.”
The idea of ProCredEx is to create a network and an infrastructure that allows organizations to safely and securely transfer credentialing documents between each other, with the practitioner in question controlling and approving that data sharing, usually via a mobile app or tablet. That network uses distributed ledger technology to track and verify the credentials, built into a network architecture that facilitates trading of credentials.
To make the network work, ProCredEx will need to get a lot of payers, health systems, and providers on board. That’s what they’ve been working on since they launched at HIMSS18 earlier this year.
“Scale is success for us,” Begando said. “You can’t build a market, like a supermarket, and open it with great fanfare, and have folks walk in and see a bag of coffee and an old sandwich. People are not going to want to buy things from your market. … We’ve announced six [members], we’ve got another 20 or so in the pipeline, and we are likely to come to market with 12 to 15 organizations that bring that initial supply to the market that we need.”
Credentialing is important for all organizations, but becomes especially critical in telemedicine use cases, which can exponentially increase the number of certificates and credentials a doctor needs to practice.
“If you’re doing like telestroke, for example, and you’ve got 10 neurologists in a teaching hospital to deliver a telestroke program to 100 or so critical access facilities within about a two-mile radius of your organization, it can take years to get those 10 neurologist credentialed in each one of these hospitals where this frankly critical service needs to be delivered,” Begando said.
Begando will be talking about ProCredEx, blockchain, and other aspects of the company like AI and data science, at HIMSS19 in a session titled “Leveraging Blockchain to Transform Clinical Credentialing.” It’s scheduled for Thursday, February 14 from 8:30-9:30 a.m. in room W304E.
HIMSS19 Preview
An inside look at the innovation, education, technology, networking and key events at the HIMSS19 global conference in Orlando.