An effort to standardize and streamline the credentialing process of federal physicians will move forward this month with the delivery of a prototype databank system to the Department of Veterans Affairs.
The VetPro system is scheduled to be installed in all 162 VA medical centers by the end of 1999, enabling facilities to swap verified data on the estimated 40,000 physicians and dentists who work or train at VA facilities.
The system is modeled after HHS' National Practitioner Data Bank, a system to identify substandard doctors and commonly used in physicians' credentialing. Like the NPDB, VetPro is being developed and operated by contractors and is overseen by federal agencies.
In the long run, the project may serve as a platform for the Federal Credentialing Program, an effort to allow all federal agencies that employ practicing physicians to share verified data on physicians' work history, education and specialty certification.
VetPro has been designed to improve the accuracy of data and eliminate duplication for both physicians and credentialing coordinators, and it has some of the same features of credentialing systems being implemented in the private sector by regional health systems and credentials verification companies (May 18, p. 41).
Significantly, the VetPro system enables the government to apply uniform standards for credentials verification. One hurdle to data-sharing has been that one agency may not trust the quality of another's data.
VetPro should enhance accuracy by guiding operators through the credentialing process, automatically cross-verifying data and blocking the operator from proceeding should a gap or inconsistency arise, said Steven Permison, M.D., chief medical officer of the quality assurance division in the HHS' Bureau of Health Professions.
"People are watching to see what happens with VetPro. If it is successful, I see it growing into a true federal network," he said. Permison has been spearheading the data-sharing effort for more than two years.
The amount of collected and stored data could be enormous, as it would include providers who are licensed or certified-such as lab technicians, physician assistants and psychologists-as well as physicians, Permison said.
VetPro data will address the needs of the Joint Commission on Accreditation of Healthcare Organizations, the National Committee for Quality Assurance and the American Accreditation Healthcare Commission.
The military already has in place the Centralized Credentials and Quality Assurance System, developed to remedy delays in assigning physicians during the Persian Gulf conflict.
Other agencies that credential physicians include the Indian Health Service, the National Institutes of Health, the U.S. Centers for Disease Control and Prevention, and programs that bring physicians to underserved areas.
Demonstration projects are under way in Albuquerque, where the Air Force and the VA are sharing credentialing data, and in Alaska, where the Air Force, Army, Navy, Coast Guard, VA and Indian Health Service, as well as native American tribal organizations, expect to exchange such data by the end of the year.
VetPro also includes what Permison calls an "optical jukebox" that electronically stores documents such as letters of recommendation.
Data will be transported via the Internet, thus providing easy and flexible access. For example, physicians could complete the standardized credentialing form on-line in their offices.
The government expects the system to save millions of dollars annually on the cost of credentialing. Permison said the system might reduce the cost of physician re-credentialing-which is undertaken every two years-from $100 to less than $10.
The project has no budget and is being funded with contributions from participating agencies. The VA earmarked
$1 million for VetPro this year, most of which remains unspent, Permison said.
He sees the project as a "community effort." The federal credentialing World Wide Web site, www.credentialing.org, includes information about educational events sponsored by a variety of nongovernmental organizations.
A federal credentialing steering committee that includes private-sector organizations such as the American Medical Association, the Federation of State Medical Boards and the major accrediting bodies has been formed to help develop the system.
If successful, the system could serve as a model for the private sector, although it won't be for sale.
"The concept (of sharing verified credentials) could be applicable universally. To that end, we're meeting with the different proprietary software companies to encourage them to agree on one standard credentialing report to facilitate the exchange of data on a national basis," Permison said.