Improve Decision-making, Reduce Variability, and Optimize Patient Care with New Smart Logic Functionality

Improve Decision-making, Reduce Variability, and Optimize Patient Care with New Smart Logic Functionality

Jul 27, 2023
  • Author:
    Noelle Abarelli

Working better and smarter, that’s what we all strive for, isn’t it? That’s definitely a goal of ours, which is why we recently released a smart logic functionality within Privilege smart logic. This new smart logic offered in CredentialStream® leverages industry-leading content (vContent) and unique curated data sets (vSource tables, VVP, and Insights) to assist in the speed, efficiency, and effectiveness of evaluating data during specific credentialing workflows. Privilege smart logic will help clinical and non-clinical decision-making, reduce variability, and optimize patient care delivery. Curious to see how it all works? Watch a recording of our webinar, CredentialStream Just Got Even Smarter: Use Smart Logic to Connect Privilege Smart logic Data or read below for a summary of the webinar for the main takeaways.

Take the Sting out of Privileging

Privilege with CredentialStream Smart Logic functionality was created to facilitate the privileging process for providers and reviewers. Its purpose is to proactively make use of information about a provider’s education/training/board certification for privileges that are already contained within CredentialStream at the time the provider applies for privileges. It was also designed to help ensure that privileging criteria are clearly identified, obtained and that it’s clear to the decision-makers during the credentialing process whether or not criteria have been met.

The idea of smart logic functionality is to be more intentional about the process, and, well, more logical too. So that now, at the beginning of the application process, when the provider is filling out their application and deciding what they are requesting, the system automatically flags and indicates whether or not certain criteria for privileges are being met. Now that we understand the why, let’s dig into the how.

Privilege with CredentialStream Smart Logic — Features

CredentialStream has a provider Hub, which gives clinicians the chance to complete a variety of tasks, including their application. Within the privilege section of the Hub, the smart logic feature assists by confirming met requirements or by flagging any unmet needs.

  • If smart logic is unable to find a record that matches a particular qualification, it will be indicated in red within the required qualifications area of the privilege form.
  • If the provider requests one or more privileges requiring those qualifications, and then attempts to proceed through the application, a pop-up warning message will appear. They can then choose to:
    • Modify their privilege requests accordingly, which most times looks like the removal of one or more privileged line-item requests.
    • Opt to resolve the matter later. This means it will be pushed to a later part of the process, at the Review Information screen, which is part of the application.

Once the application is submitted through the Hub, the Medical Services Professional (MSP) will be presented with indicators of unmet qualification on the Application Review Screen. CredentialStream users will have the chance to review comments made by the provider and make any additional comments they believe reviewers down the line may find helpful. Users can use that same Application Review Screen to discuss missing criteria and, if applicable, eventually resolve the unmet qualification, which would then remove the comment altogether once it’s been addressed.

Note: The information grid on this screen allows for a column filter. One of the filters is called “Qualifications Met.” While using smart logic functionality, users can configure the grid to include this column so that any information related to the fulfillment of qualifications can be displayed.

Once the provider has submitted their application and the MSP has made their contributions, the application is ready for clinical review by the Chair or Chief. While in the Hub, the reviewer will receive an alert regarding any qualifications that have been flagged on any given privilege form. They will also have the ability to make recommendations and determinations on the form in the same way they do now.

These features:

  • Will save time and spare confusion and frustration
  • Foster clarity and confidence in your overall privileging process
  • Can be used during a full initial or re-credentialing application and are also available for use within mid-cycle and temporary privilege processes

CredentialStream Smart Logic — Configuration Details

One thing to note about the smart logic functionality is that it is only available to current CredentialStream users. When you’re ready to use the feature, all you have to do is navigate to the System Parameters System Settings tab and locate the Privilege Settings area. There you will be given the option to set the new toggle called “Use Privilege smart logic for Qualifications” to the yes position, and it will be activated.

For now, smart logic applies to two qualification types:

  • Education and Training: The toggle may be set to require current or unexpired education.
  • Board Specialty: Up to three additional board specialty records can be selected. Or, for advanced providers that don't have ABMS or AOA, additional fields can be made available as needed.

CredentialStream ensures that any areas being utilized by the smart connections from the provider Hub are automatically available within the Apply configuration.

Rigor and Ease in One Solution

Rigorously assessing the clinical competency of your caregivers is key to ensuring that competent providers are delivering quality patient care. With this functionality you can:

  • Assure privileging criteria are clearly identified for all stakeholders
  • Ensure providers meet the required qualifications as they request privileges
  • Cut out unnecessary back-and-forth communication

For more details on how to make best use of smart logic functionality, watch a recording of the webinar. Or, for any other questions you may have, simply reach out.