Expanding Access For a Growing Network

About the Customer

Sentara Healthcare was first established in 1888 asa 25-bed retreat for the sick in Norfolk, VA. Overthe past 135 years, they have grown to be oneof the largest not-for-profit integrated healthcaredelivery systems in the Mid-Atlantic region of the US.Recognized nationally for clinical quality and safety,Sentara Healthcare is strategically focused oninnovation and creating an extraordinary healthcareexperience for its patients and members. Theirmission to improve health every day is reflected intheir commitment to keeping their patients safe andinformed, treating them with dignity and respect,and working together to provide the best care.

Overview

In January of 2023, Sentara Healthcare acquired AvMed, a not-for-profit health planheadquartered in Miami, FL. AvMed provides commercial group, individual, and MedicareAdvantage coverage to more than 200,000 members. But Sentara Healthcare's growthdidn't stop there. Shortly after, in conjunction with Infinite Computer Solutions, OptaFi, LLC.was created, a joint venture focused on supporting healthcare companies to deliver digitalhealth. OptaFi provides a reliable pathway to digital health by leveraging cloud migrationexpertise and an in-depth understanding of healthcare operations, security, compliance, andtechnology.
Attempting to meet the needs of multiple divisions housed under one umbrella, quicklyexposed some shortcomings in Sentara Healthcare's credentialing and privilegingprocesses. But as an organization committed to innovation, Sentara Healthcare quickly setout to make the necessary changes needed to service their growing organization.

Laying the Groundwork

Sentara Healthcare is no stranger to making necessary changes for the benefit of theircommunity. Back in 2011, after determining there was a need to upgrade their privileging andcredentialing processes, they successfully implemented EchoCredentialing. That transitionhelped Sentara Healthcare navigate one of the most taxing healthcare crises the world hasfaced - the COVID-19 pandemic. But with mergers on the horizon, there came a need for amore robust solution to facilitate collaboration between all of Sentara Healthcare's new andexisting entities.

Key Challenges

• Lack of Standardization Because of the multiple mergers and acquisitions that took place, standardization across all the divisions became one of their biggest challenges. Four governing bodies within a single system meant a single CVO was tasked with processing applications for 11 of 12 hospitals. And within those 12 hospitals, there were 11 separate medical staffs to work with. There were variations between delineation of privileges (DOPs) being used and the criteria within them, and each of the individual medical staff committees met on different dates. With no standardization in place, the work became cumbersome and unmanageable.
• Onboarding Challenges: Hand in hand with standardization came complications with onboarding. The real problem Sentara Healthcare faced lay in onboarding the same provider at multiple facilities.
• Privileging Predicament: Privileging providers is a complex process in itself, maintaining multiple processes across varying facilities wasn't sustainable.

"We were drawn to a solution likeCredentialStream because of its ability tostandardize delineation of privileges at any giventime, a functionality we desperately needed."

Carla Allen, Medical Staff Coordinator, Sentara Healthcare

Solution Selection Process

EchoCredentialing was a great solution for Sentara Healthcare at first. It empowered themto go paperless and helped auto-process their workflows, reports, and rosters while keepingaccurate records. But with the acquisition of AvMed and the creation of OptaFi, SentaraHealthcare was having problems with duplicate records, complications with system-wideupdates, and a lack of transparency within the application process. CredentialStream waschosen as the solution to address those issues, and more.

Validated, integrated, and continuously updated vSource data tables: This providesSentara Healthcare with information about facilities, schools, payers, and license boardsthat is up-to-date, accurate, and reliable, helping them avoid errors and duplicate data.

Ability to apply changes in batches: Sentara Healthcare will now be able to provide thesame updated document to multiple providers in a single step, as opposed to needing todo so for each individual.

Ability to standardize documents and release forms: CredentialStream's continuouslyupdated, best-practice content libraries, and industry-leading data sets make standardizingdocuments across all divisions easier and seamless.

The Provider Hub: With a centralized portal, Sentara Healthcare can offer providers andclinical leaders a direct connection to key credentialing processes and information, andthe ability to maintain their own profiles, preferences, and much more.

Implementation

Sentara Healthcare knew it was necessary to build a team of dedicated resourcesfor seamless integration. They designated a dedicated IT Manager and severalexecutive sponsors from the IT and Medical Staff departments to focus on the switch toCredentialStream. They appointed a Process Improvement Engineer to lead all meetingswith specialty representatives to keep all team members on track and accountable forDOP approval. Selected team members worked together in tracking and documenting alldecisions to ensure the project moved at the desired pace. They also:

• Created a data map so that all existing data could be easily found within EchoCredentialing in preparation for migration.
• Worked on code conversions so both systems could communicate seamlessly.
• Simultaneously embarked on a privileging project in order to standardize their DOPs from the get-go.

"Overall, it's been a positive experience makingthis transition, though it's been challenging with somany puzzle pieces to keep track of, especially withteam members on both sides. I'm excited to see thepositive impact CredentialStream will have on theprovider experience across the organization."

Carla Allen, Medical Staff Coordinator, Sentara Healthcare

Looking Ahead

Sentara Healthcare is still in the process of migrating its data from EchoCredentialing toCredentialStream. As they look ahead, they plan to continue learning and growing withthe technological advancements that come their way. They are committed to pushingtheir limits and thinking outside the box while using all the features CredentialStreamcan offer to the fullest extent. As they complete the migration process, they are lookingforward to:

Standardized DOPs: Using CredentialStream's library of best-practice privilege forms tostandardize their DOPs. With data at their fingertips, there will be fewer questions fromthe CVO, leadership, and physicians.

Improved customer service: Providers have access to more accurate informationregarding what is required of them, leading to improved levels of satisfaction on both theprovider and patient side.

Process improvements: With less time spent working in a non-centralized system,Sentara Healthcare and its acquired facilities will be able to credential and privilegeproviders more quickly leading to overall efficiencies.