Consulting Connection Blog

Since the first U.S. case of the 2019 novel coronavirus, which causes a disease known as COVID-19, was confirmed in a man from Washington state in January 2020 our world and the way we function in it has been turned upside down. From wearing masks in public, to staying six feet apart, then isolating at home, to finally getting a vaccine for the virus…this has changed not only our private lives but how we have adjusted to the ever-changing requirements to be able to continue to work in our daily routines.

Now two years later, we want to examine changes that were made to continue to perform the vital role that Medical Staff Professionals play in healthcare organizations.

Ann Klinger, CPCS; Director; OHSU Health Medical Affairs

To get a better understanding of how one organization adapted their coverage of their Medical Staff Committees, I reached out to Ann Klinger, CPCS, who is the Director, OHSU Health Medical Affairs for Oregon Health and Science University (OHSU), an Academic Medical Center, and Hillsboro Medical Center (HMC), a community-based Hospital. She manages 13 employees overseeing the credentialing and privileging for the medical staff offices, which also includes a Credentialing Verification Organization (CVO) and delegated credentialing arrangements.

Ann received her bachelors from Oregon State University and her Master in Technical Management, Health Services Management from DeVry University Portland. She is nationally a Certified Provider Credentialing Specialist (CPCS) and recently served on the board of the Oregon Association Medical Staff Services (OAMSS) as the Secretary and Scholarship Coordinator. Ann is also the lead instructor for the OAMSS pre-certification study group and Credentialing Basic classes, since 2011 and now a NAMSS volunteer for their Conference Committee.

What was your medical staff committee meeting process prior to COVID?

We had to make sure you scheduled the conference room(s) at least one year in advance, especially for recurring meetings, or as soon as you knew the booking option for your time frame was available. This was done either via Outlook, or a dedicated conference room scheduling software. There were some rooms that you had to contact an Executive Assistant to schedule on your behalf. We met in person and provided food at some of our meetings. Meeting invites were sent out via Outlook. We would have some individuals “call in”, but we didn’t use web cameras at our meetings, so it was always just a dial in function. It was preferable to have everyone in attendance. Presentations would be displayed on giant video screens in conference rooms, but they could not be seen by individuals on the telephone. Guests would show up to the conference room at the appointed time. We would email meeting packets ahead of time, but we always made copies of agendas for the meetings and placed them at each seat at the table. Sometimes we would have to make copies of an additional item that was not part of the packet and have to make copies for everyone in attendance. For Credentials Committee we always made copies of everything that was sent out for the Chair, so they had everything right in front of them at the meeting.

How many medical staff committee meetings did you cover?

At OHSU three: Credentials Committee, the Professional Board (Medical Executive Committee) and our Annual Physician meeting. At Hillsboro I cover five meetings, but my HMC team also supports an additional eight meetings.

Once COVID restrictions were instituted what immediate changes were made?

Everything converted to virtual and utilizing WebEx which we were informed was the dedicated platform for virtual meetings. I remember sitting at our Professional Board meeting in February 2020 and we had just learned of the first COVID case in Oregon. At that meeting we were told it was probably going to be our last in person meeting for about a month (that has been a long month). As COVID continued on we had to decide what do about our annual physician meeting because that is where we presented awards in person and recognized medical staff. Web cameras had to be purchased for many employees as well.

For the MEC we had to utilize protected spaces for documents that could not be emailed. We originally utilized “Box”, but that has gone away. Now we utilize Microsoft Teams and only grant access to the members of the committee. Meeting items are deleted within one week of the meeting being held.

How did the medical staff committee members respond?

They seemed to adjust pretty well. Everyone understood why we had to do this. One of the main adjustments was getting everyone to use their mute button. Some would have trouble with the meeting link, and we would help educate them, or explain to them where the dial in information was located. It also became interesting to see committee members in their homes, or offices. The one thing they missed was the ability for an in-person side bar conversation. They had to get use to the chat function and making sure they weren’t sending private conversations to everyone.

How did your Medical Staff Services staff respond?

They pivoted right away. Adobe Portable Document Format (PDF) became our friend and since we are very familiar with PDFs it was easy to put the meeting packets together. Creating email distribution lists for committees became important because we needed that information to mail out meeting packets. Those that support meetings utilize meeting record function. I have noticed that since we no longer copy items that some meeting packets are not sent out as early because we just email them. It is so nice to not have to dedicate time (actually schedule time) to stand at a copier.

We are now more than a year into the COVID restrictions, what are your current medical staff committee processes?

No conference rooms have to be scheduled. You just have to make sure everyone has been sent the meeting invite for the correct day and time and you include the WebEx information on the invite. We do not copy any documents. Meeting packets are sent out to the attendees via email. All food budgets for meetings were eliminated. Our meetings still follow their same format. The individual who supports the meeting is the one who has to share their screen for presentations (sometimes the Chair or guest presenter takes on that duty), monitor the chat function to make sure the Chair doesn’t miss a question, and make sure you are listening for the words ‘next slide please’. Besides taking the minutes you have more to monitor in the virtual world.

Have any of the changes made during COVID become permanent?

I feel like all of our changes will be permanent even when we can meet in person. WebEx will remain as the meeting platform; all information will be sent out electronically. Microsoft Teams has become the latest program to utilize especially to house and secure committee documents.

If you were to look back is there anything you would have done differently when all of the restrictions were first implemented?

Make sure my team had working web cameras and test the virtual meeting environment. Even though my team seemed to take right to it I could have spent a few extra minutes making sure those who support meetings were comfortable with the process and that everything was working for them. Nothing bad happened, but it was just like ‘everyone…here you go, all meetings are virtual and here are the directions for WebEx. If you have a question let me know.’ I also know my team has been concerned when they hear the words “modified operations” that we will have to attend meetings in person. I have explained to them our team is a telework only team and they will not have to attend meetings in person.

Jackie’s Comments

I can’t thank Ann enough for taking the time out of her busy schedule to answer my questions and contribute to our Life Amid COVID series.

We have found that most clients have adapted very well – even those who believed that they could never do electronic only meetings or telemedicine but were suddenly forced to do both. I have always thought the one constant in the life of a Medical Staff Professional is “change.” Changing staff, changing regulatory requirements, changing software…MSPs are consummate professionals who when faced with an unthinkable challenge never fail to face the challenge head on and succeed.