By Rod Moore
Most, if not all, Texas hospital
leaders have experienced
the painful and costly process
of onboarding new physicians
and other health care professionals.
It takes months to complete, impedes
access to care and delays potential
reimbursement. The manpower
required to gather and verify professional
credentials, including state
licenses, medical malpractice insurance
or certificates, is an integral
part of that onboarding process but is
often the culprit behind delays.
New software is emerging in an industry
rife with promises of disruption,
but with each comes the inherent need
to invest hundreds of hours worth of
human resources. A shift in this paradigm
is occurring with one leading
company hoping to change the way
credentialing teams
store and research
critical physician
data.
While the credentialing
process typically
takes 90 to 120 days, in some extreme
cases verification of academic
and professional credentials can take
many months to complete. Hospitals
report nightmarish scenarios where
credentialing has taken six months
to a year.
With Professional Credential
Exchange, known as ProCredEx,
however, hospitals have a trusted,
reliable means of exchanging credentialing
data and documents between
themselves and other entities. Pro-
CredEx is professional credentialing
exchange backed by Hashed Health,
a company that provides health care
blockchain solutions. The ProCredEx
solution uses a combination
of advanced data science, artificial
intelligence and blockchain technologies
to simplify the process. With it,
hospitals will be able to get clinicians
to the bedside and able to file claims
under their own credentials quicker.

Begando
“I believe the No. 1 financial advantage
(of the exchange) is just improving
revenue forfeitures,” said Anthony
Begando, CEO and co-founder,
ProCredEx.
During this lengthy onboarding
process, hospitals forfeit the opportunity
to bill for care provided.
“The average daily net revenue for
physicians is about $7,500, which is
$150,000 a month,” said Begando.
“If you’re talking about a four- to
six-month-long process, you're looking
at anywhere from $600,000 to
$900,000.”
Credentialing and enrollment
software is a useful tool but doesn’t
solve the main problem of obtaining
and verifying the actual credentials.
Many of the requests to verify
credentials still require documents
to be exchanged by fax machines or
through mail delivery.
With new technology, however,
comes new opportunities to disrupt
traditional processes.
Untangling the Costly Onboarding Process
Although verifying professional records
— which includes authenticating
licenses, education, certifications and identification — is painstaking
and requires many hospital administrative
staff hours to complete, very
few alternatives have been available
to hospitals to expedite the process.
Each credentialing body has its
own verification processes and requirements,
making the process even
more complex. As providers move
among hospitals and health care systems,
that set of credentialing data
must be gathered and verified anew.
While there are some variations in
the set of data required by one hospital
to another, redundancies abound.
Over time, practitioners can easily
accumulate redundant data sets with
12 to 25 different entities.
Yet because of a lack of external
authentication, the new hospital will
dedicate significant labor costs into
the credentialing process because a
more streamlined alternative hasn’t
existed before now, said Begando.
For example, Begando explained,
Hospital A may spend many staff
hours to obtain and verify records
related to a medical malpractice lawsuit
in order to onboard a new physician.
Yet, when the provider moves on
to Hospital B, a new hospital credentialing
professional will have to do
the legwork to verify the malpractice
suit all over again. Hospital A’s staff
time investment is lost while Hospital
B’s is stuck redoing work while losing
revenue.
In the existing system of gathering
and verifying credentials, there was
no way for Hospital B to obtain the
necessary records directly from Hospital
A — and no means for Hospital
A to profit from its own credentialing
staff’s time investment.
ProCredEx is not a ‘credentialing
system’ but rather a secure and
reliable market for members of the
health care community to trade verified
credentials among themselves.
The exchange does not replace but
rather works alongside a hospital’s
existing credentialing software. By
simplifying what was once the analog
legwork portion of a credentialing
professional’s job with a fast and
efficient way of gathering and sharing
necessary documents, the exchange
does not require hospitals to switch
credentialing software.
Benefits of a Credentialing Exchange
By using blockchain technology,
documents that previously have been
verified by one organization can be
shared with another quickly, safely
and securely. As a result, Begando
sees the entire credentialing process
going from months to soon being
measured in days.
Importantly, the advantage of
blockchain is the preservation of
trust. If even a single pixel changes
on a document, the blockchain technology
would break the document’s
authentication (or “lock”), and it
would be rejected.

Rische
Christian Rische, advisor, venture
capital, Spectrum Health Ventures
in Grand Rapids,
Michigan, became
an early supporter
of ProCredEx when
he was introduced
to the program by
John Bass, founder
and CEO of Hashed Health, while at
SXSW last year.
“If you look at credentialing within
hospitals since the early '90s, nothing
has changed,” Rische said. “People
are using faxes and phone calls to do
this work when it's really just documents.
Once they're scanned in, we
should be able to figure out a way to
get them to people faster and easier.”
Rische is optimistic that hospitals
using ProCredEx will be a success,
given how much progress has been
made with various work groups
during early pilots to ensure the
exchange syncs with existing onboarding
systems in hospitals. The
company has roots in the security
and military community, and first
used the techniques to speed up confirmations
of various clearances and
credentials needed for professionals
within that environment