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A look at the revised telemedicine standards

Credentialing Resource Center Connection, October 12, 2006

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The revisions to the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) telemedicine standards MS.4.120, effective July 1, 2006, require a higher standard and responsibility by hospitals when they use credentialing information from a JCAHO-accredited ambulatory care organization. The hospital, as the "originating" site, is obligated to ensure that the ambulatory care organization (the "distant" site) meets the JCAHO's hospital standards related to credentialing and privileging (MS.4.10 through MS.4.20). The revisions also hold the ambulatory care site to a higher standard of credentialing and privileging. The expectation is that the same yardstick will be used for all practitioners providing care, treatment, and services to patients within a hospital setting.

This week we'll address the Medical staff standard MS.4.120 addresses licensed independent practitioners (LIPs) who have total or shared responsibility for patient care, treatment, and services through a telemedicine link. Within this article we are not referring to those LIPs who provide official readings of images, tracings, or specimens (interpretative services) and are allowed to be processed under the contracted service standards (LD.3.50).

Under MS.4.120, under special circumstances, a provision exists for the option of credentialing and privileging by proxy. One of the following must occur:

1) Credentialing and privileging by the originating site for the services provided to the patient must be performed according to MS.4.10 through MS.4.110
2) The originating site may use the credentialing information and/or the credentialing and privileging decision from the distant site to make a final privileging decision by the governing body of the hospital if the distant site is a JCAHO-accredited hospital or ambulatory care organization

Aligning the credentialing and privileging standards for hospitals and ambulatory care settings is a prudent move. Once established, this process should allow for medical service professionals to trust that the information they receive from a JCAHO-accredited distant site is equivalent to the credentialing and privileging data that their own institution would have generated.

Your facility's credentialing process may go beyond what is required by the Joint Commission. If so, ensure that a consistent standard is applied for all practitioners. This may require additional due diligence on the part of the originating facility (e.g., obtaining criminal background checks).

Remember, credentialing has no other master than the patient.

That's all for this week.

All the best,
Sally J. Pelletier, CPMSM, CPCS

Sally J. Pelletier, CPMSM, CPCS, is a consultant with The Greeley Company, a division of HCPro, Inc. specializing in the areas of credentialing and privileging.

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