Credentialing & Privileging

JCAHO announces changes to Type I appeals, telemedicine standards, and more!

Credentialing Resource Center Connection, January 10, 2003

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At the JCAHO surveyors' conference in Chicago this month, the accreditor revealed upcoming changes to its standards and procedures.

Starting in January 2004, you'll no longer be able to challenge Type I's except when you can prove that surveyors didn't look at enough of a sample size, such as six medical records rather than 30, says a source close to the JCAHO. When surveyors hit "print" on their laptops at the end of survey, it's no longer to produce a preliminary report but a final report.

The JCAHO also will eliminate supplemental recommendations. You'll either receive a Type I or an "information finding" (the JCAHO didn't give this rating a formal name), which means the JCAHO will look for informational findings on how you improve your weak area(s). You won't have to fix "information findings." Currently, you have to fix supplementals or get a Type I.

The JCAHO will adjust scoring guidelines to the sampling size, but did not explain how.

Additionally, you won't have to submit paperwork-heavy correction reports to the JCAHO. The accreditor will instead hold verbal discussions over the telephone on resolving Type I's.

In addition, the JCAHO will clarify telemedicine standards MS.6.10-MS.6.10.1 by placing physicians into three categories: consulting physicians, interpretive physicians, and treating physicians. Treating physicians-such as dermatologists who look over skin rashes via telemedicine-diagnose and treat patients and must therefore have hospital privileges. Interpretive and consultative physicians don't need privileges, with the exception of radiologists who interpret films and check the patient's record and must therefore undergo the credentialing process, the observer says.

The accreditor also will add an intent statement to standard MS.5.4.3.1 (seeking primary-source verification) to state that it's acceptable for hospitals to use a medical school-approved designated agent rather than going directly to the school for primary-source verification.

However, keep the letter from the medical school to prove that designation and thus that the hospital did indeed seek primary-source verification.



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