Credentials, fads and the key to future success

Mary Stevens, Editor

Telemedicine faces its share of hurdles, but CMS is getting ready to lower one of the regulatory stumbling blocks. And none too soon: As we wrote in the cover story of the May issue of CMIO, because physicians are licensed and credentialed by state, it can be difficult for them to practice across state lines—as telemedicine requires in many areas.

On May 26, CMS published a notice of proposed rulemaking (NPRM) to revise the conditions of participation (CoPs) for both hospitals and critical access hospitals to allow a new credentialing and privileging process for physicians and practitioners providing telemedicine services. The proposed rule, published in the Federal Register, would apply to all hospitals and critical access hospitals participating in the Medicare and Medicaid programs.

“CMS has become increasingly aware …of the urgent need to revise the CoPs in this area so that access to these vital services may continue in a manner that is both safe and beneficial for patients and is free of unnecessary and duplicative regulatory impediments,” stated the NPRM.

Telemedicine is gaining momentum, but the medical home model is “at risk of becoming the latest fad in a long history of unrealistic expectations and failed health reform efforts,” write authors Charles M. Kilo, MD, and John H. Wasson, MD, in the May issue of Health Affairs. The authors took a long view—spanning 40 years—of efforts to redesign office-based medical care, and found that unrealistic expectations, declining numbers of primary care physicians and the still-undefined role of the patient could derail efforts at establishing sustainable patient-centered medical home models.

Kilo and Wasson’s conclusion isn’t revolutionary, but should be taken to heart: “primary care alone cannot solve healthcare’s cost and quality challenges. Successful reform must focus on substantial payment redesign, overall health system reorganization and much more.”

So is the stage is set for the next 40 years of practice reform? Not without the people to put the systems in place. In a cold economy, the health IT field is hot, according to a trend study by the University of California San Diego Extension. Federal initiatives encouraging the adoption of advanced IT systems are fueling the demand for health IT pros who can support medical record reform.

To bend a famous line from “The Graduate,” the key to future might not be one word—plastics—after all.

Mary Stevens, Editor
[email protected]