Joint commission

Joint commission bows out of vendor credentialing debate

Despite much anticipation on the part of the supplier community regarding potential Joint Commission standards surrounding vendor credentialing, the Oakbrook Terrace, Ill.-based accreditation organization quietly stopped working on the issue earlier this year. A spokesman said that Joint Commission decided it was not in the business of developing standards of competence for healthcare industry representatives, that is, sales reps. Instead, Joint Commission is recommending that the industry turn to “professional organizations…recommending general credentialing requirements,” citing AdvaMed, which created a set of recommended credentialing requirements with AORN, the Health Industry Distributors Association, IMDA (specialty distributors) and other organizations. (One of those organizations, AHRMM, withdrew its name from the document in June, though the reason was unclear.)

No public announcement was made of the decision. But suspicions arose when one IMDA member became aware of a Joint Commission communiqué on the topic, presented as a “Question-and-Answer” on the organization’s Web site. In response to the question, “Does the Joint Commission have requirements related to credentialing health care industry/vendor representatives who are involved in care, treatment and services provided by professional staff in accredited health care organizations,” the Joint Commission makes the following statements:

• The Joint Commission has no standards that specifically address healthcare industry/vendor reps.
• There are no accepted national standards on competence for sales reps.
• There is “no specific licensure, certification, or registration for health care industry/vendor representatives….”

Although Joint Commission begged off on sales reps credentialing requirements, it states in the Q&A that a number of its standards “are relevant to any individual that enters a health care organization who directly impacts the quality and safety of patient care.” Among them are:

• Standard EC.02.01.01, which states that in order to protect patient safety, accredited health organizations need to be aware of who is entering their organization and what these individuals are doing in their organization.
• Standard RI.01.01.01, which states that accredited healthcare organizations need to take steps to ensure patient rights are respected.
• Standard IC.02.01.01, which states that accredited healthcare organizations need to take steps to ensure that infection control precautions are followed.

Joint Commission also cites standards relating to the development and implementation of a patient safety program (LC.02.02.05 EPs 1, 3 and 4).

At IMDA’s 2008 Annual Conference in Oak Brook, Ill., Laura Smith, associate project director for the Joint Commission’s division of standards and survey methods, said that the organization hoped to have suggested recommendations about vendor credentialing – called a “field review” – completed and ready for comment by the end of 2008. At that time, Smith said that while Joint Commission was intent on coming up with some general credentialing requirements for sales reps (incorporating, perhaps, such things as knowledge of HIPAA, training on infection control, etc.), it was especially concerned about establishing guidelines on the competence and knowledge of reps who call on patient-care areas, such as the OR. Patient safety is the organization’s primary concern, she said, adding that Joint Commission was also investigating whether it should recommend that reps – particularly those calling on patient-care areas – demonstrate knowledge of the products they sell.

Premier explores potential contract
Meanwhile, at press time, Premier healthcare alliance had issued an RFI to vendor credentialing firms, but had not made a decision whether to proceed further and pursue an RFP for a contract for vendor credentialing services.

“At this point, we don’t know if we’ll move forward with a contractual relationship with any or many [vendor credentialing companies],” said Pam Daigle, director of sourcing. “Our members requested we pursue this path. Our intent is to understand the need [for a potential contract] and what the cost structure looks like.” Daigle said that some suppliers have “reached out to us, trying to make sure we understand the supplier side of this equation. We are absolutely aware of that, and we want to make sure we fully understand the impact.”

Premier Vice President of Supplier Relations and Business Development Dave Edwards said that vendor credentialing calls for a balancing act on the part of suppliers and providers. “It is the hospital’s right and obligation, from a compliance standpoint and patient safety standpoint, to know who’s in their hospital, what they’re doing, and whether they have a specific reason to be there,” he said. But it is not in the hospitals’ best interest to use vendor credentialing to close the door to vendors. “Hospitals recognize that reps bring new technology. They know that the orthopedic rep is central to the delivery of [an orthopedic case], coaching physicians on procedures and services. The same is true with the cath lab, electrophysiology [and other specialties]. Hospitals won’t cut off their nose to spite their face.”

Research conducted by Downers Grove, Ill.-based IMDA, an association of medical specialty distributors and reps, shows the following information regarding GPO contracts with vendor credentialing companies:

Amerinet: Contract with Vendormate.
Broadlane: No contract.
HealthTrust Purchasing Group: Contract with PreCheck, which offers the VendorCheck program.
MedAssets: No contract or endorsement, though the GPO reports it is working on a program.
Novation: No contract.
Premier: RFI issued.

Editor’s Note: To view the entire Joint Commission Q&A, go to http://www.jointcommission.org/AccreditationPrograms/LongTermCare/Standards/09_FAQs/HR/hc_industry_vendor_representatives.htm.