Bozeman Health manages the credentials for more than 1,000 practitioners across southwestern Montana. This includes active medical staff, telehealth, locum, advanced practice clinicians and independent healthcare providers.

THE PROBLEM

The health system's previous credentialing process was inefficient and burdensome, relying on manual workflows, physical forms and in-person provider signatures. This created a logistical burden on both medical and administrative staff.

"As a result, we were seeing slow application turnaround times," said Heather Holmquist, RN, system manager of medical staff services and peer review at Bozeman Health. "Leaders had little visibility into the status of credentialing applications, thus making it difficult to adequately prepare for credentialing committee meetings. During the COVID-19 pandemic, we also dealt with staffing shortages and struggled to onboard new providers in a timely manner to meet the growing demand for care.

"We further were concerned our manual credentialing system allowed for higher risk of human error," she continued. "All of these challenges ultimately were creating a financial burden on the organization, impacting patient access and therefore patient experience."

PROPOSAL

Vendor RLDatix promised Bozeman Health that its technology would bring the health system's credentialing online and make it easier for everyone involved. A streamlined credentialing system would help Bozeman achieve true compliance and align with industry best practices by creating a comprehensive, electronic database of provider files, the vendor said.

"This would enable increased process visibility while also maximizing staffing resources, dramatically reducing credentialing turnaround time and improving recruitment efforts," Holmquist said. "A centralized repository of digital data facilitates access to information quickly and efficiently. The system would allow providers and staff to upload information from anywhere.

"Using dedicated queues and hardcoded timestamps for assigned work, credentialing teams could monitor progress and maintain tight quality controls for patient safety and overall experience," she added.

The technology also would enable committee members to have early access to provider files, enabling comprehensive review and committee preparation, she said.

MEETING THE CHALLENGE

Through working with the vendor, Bozeman Health was able to drive significant change across the health system. The credentialing teams use the platform to manage applications and re-applications without the need for physical paperwork, in-person signatures or faxed documents. Everything is digitized and located in a centralized database for easy access.

"The technology integrates with our other RLDatix software for peer review, patient safety and patient relations, as well as with our systems from Epic and Premier," Holmquist noted. "This was especially critical to us in choosing the right technology to implement. We wanted something that would fit seamlessly into our existing tech stack so we weren't creating an additional administrative burden on staff.

"The RLDatix infrastructure has provided greater efficiency for managing provider classifications and large-scale initiatives – for example, the rapid collection of provider COVID-19 vaccination records – greater flexibility after hours and during emergency situations, more proactive and productive credentialing meetings, and an improved patient and provider experience," she continued.

Holmquist offers an example of the impact the credentialing system has had for the health system.

"I was at a conference, and I got a call from our CEO about an urgent credentialling issue," she recalled. "Rather than having to call my team and get them to manually pull the correct files and fax them over, I was able to log into the credentialing system right on my phone and pull up the correct file within minutes.

"Credentialing is really the first line of safety within a health system, and with the technology we've added another layer of safety checks to our processes," she continued. "Through our new process, we've been able to identify providers early in the credentialing process who did not meet our high credentialing standards."

RESULTS

With the technology, Bozeman Health has seen much faster turnaround times on credentialing applications, which helps increase patient access. A further benefit is regaining organizational revenue sooner, which also benefits the provider and patient populations.

"Specifically, Bozeman Health's turnaround times are now 40-45 days to completion, down from 90-120," Holmquist reported. "RLDatix's software streamlines the process by following up with applicants and guiding them through every step. In July 2021, before implementation, our team was credentialing an average of eight applicants per month."

Three years after implementation, the team is credentialing about 35 applications per month, more than quadrupling capacity to process applications and reapplications.

"The user-friendly system also has been a selling point in our efforts to recruit new providers," Holmquist said. "Our white glove program has gotten positive responses across the board, and we've even had locums who have come on as permanent staff because the credentialing and onboarding experience was so easy and positive for them.

"The increased automation of credentialing provided by the software has significantly lessened the administrative burden on staff, freeing up FTEs and leading to staff reallocation," she continued. "Previously, we had 3.5 FTEs focused solely on credentialing."

With the system in place, Bozeman decreased that number to 1.5 FTEs. Rather than having to manually drive the entire credentialling process from start to finish, the FTEs focus their time on handling the tasks that are not automated by the system, such as building agendas and running orientation programs. The team created a monthly physician Grand Rounds Lunch and Learn, completely reconstructed and streamlined the onboarding process, and built a new web page for providers.

"We also now have access to certified credentialing specialists through RLDatix, who have helped us to adopt best practices and improve our medical staff services overall," Holmquist noted.

"One of the top benefits we've seen is the improvement to our audit readiness," she added. "As a DNV hospital, we get surveyed multiple times a year, and these surveys require going through all our credentialing files. We are on our eighth or ninth survey audit since implementation, and we typically get through the audits in 15 minutes. We routinely receive 'noteworthy efforts' commendations for comprehensive files."

Finally, Bozeman Health has seen a strong financial benefit. In the first full year of using the software, it experienced a 25% reduction in annual spend, enabling the health system to invest funds in other high-priority areas.

ADVICE FOR OTHERS

"I would advise healthcare organizations considering implementing new credentialing technology to focus on change management," Holmquist said. "Our team was extremely engaged with garnering buy-in from our senior leaders and more than 700 staff providers prior to implementation. We scheduled multiple sessions with providers and other staff to familiarize them with the software and make sure they felt comfortable.

"Change is easier when it's gradual," she noted. "We started implementing the new process with initial applicants only. Then, seven months later, we began to use the process for reappointments. This staggered approach helped acclimate staff to the process and gave our credentialing committee time to learn with a smaller pool of applicants."