IMDA Conference

Edition: August 2008 - Vol 16 Number 08
Article#: 2986
Author: Repertoire

Suppliers urge industry to walk carefully through the vendor-credentialing thickets

OAK BROOK, ILL-If suppliers are to catch the attention of the Joint Commission in the vendor credentialing discussion, they must speak the language of patient safety. That much was clear following remarks by Laura Smith, associate project director for the Joint Commission's division of standards and survey methods, following a panel discussion on the topic at the recent IMDA Annual Conference. IMDA is the Downers Grove, Ill.-based association for specialty distributors and reps.

What also was clear, however, was that many languages are being spoken about vendor credentialing. For example, panel participant Mike Carey, director of purchasing for the University of Chicago Hospitals, defended vendor credentialing as a means of certifying that the vendors who call on the hospital work for companies that are financially viable and will remain so throughout the life of the contract. Carey added that with as many as 150 reps calling on University of Chicago every day, it is imperative that he knows who's walking the halls. Vendor credentialing can help him do that.

For his part, IMDA member Bob Byers of Tri-anim - another panel member - made it clear that he and the entire IMDA membership understand the provider community's desire to protect patient safety. But, he added, the current, chaotic vendor-credentialing status quo may actually impede or bring to a halt the introduction of innovative technology - including technology to promote patient safety - by imposing an overwhelming economic burden upon the companies that bring them to market.

Meanwhile, Peter Sheehan, founder of REPtrax, a vendor credentialing firm, argued that a properly functioning credentialing system can actually benefit vendors by sparing them the hassle and expense of jumping through the hoops of hospitals' home-grown credentialing systems.

Joint Commission

Indeed, during the panel discussion, all eyes were on Smith. The Joint Commission is planning to issue suggested recommendations about vendor credentialing - called a "field review" - by the end of the year. The public will have up to six weeks to comment, after which Joint Commission will refine the recommended guidelines.

Smith told IMDA members that while the organization is intent on coming up with some general credentialing requirements for sales reps (incorporating, perhaps, such things as knowledge of HIPAA, training on infection control, etc.), it is especially concerned with establishing guidelines on the competence and knowledge of reps who call on patient-care areas, such as the OR.

When asked about the "must-haves" in a credentialing process, Smith was clear: "Those related to patient safety," she said. "We're looking at our existing requirements for hospital staff, and deciding which of those ... would apply to sales reps."

The Joint Commission is investigating whether it should recommend that reps - particularly those who call on the OR and other patient-care areas - demonstrate knowledge of the products they sell. The question is, how would they do so? "We're looking at how physicians are privileged insofar as new equipment is concerned," said Smith. "Maybe we can use that as guidance."

Smith asked suppliers to offer their input on how the industry could monitor incompetent reps. "There currently is no system to track 'bad apple' reps," she said. "For nurses, you can go to state nursing boards. The same is true for physicians. But there is no way to track complaints or issues with sales reps. So that's something we're throwing out there to think about as well."

Hospital perspective

Carey's remarks were the subject of much anticipation, because the University of Chicago subscribes to Vendormate, a company that has aroused the ire of many suppliers because of its per-hospital or per-IDN fee.

"There are a number of risks when the medical center does business with vendors," said Carey. "Companies default, and that threatens patient care. If you're a sole-source vendor … and the source of a critical supply, and your company has filed for bankruptcy, I won't know that. But I will with a vendor credentialing company. [In addition], vendor fraud costs hospitals money. We can't afford issues with vendors, such as lawsuits. [Vendor credentialing] is about making sure we're doing business with viable organizations."

But hospitals have other concerns, which vendor credentialing can help address, he added. "We don't know who's wandering our halls …. I don't want to keep [vendors] away from Dr. Smith, but I do want to see that the right people are coming in, and that they're seeing [doctors] at the right time, so as not to be an annoyance to them." Hospitals have an obligation to make sure that sales reps know and adhere to HIPAA regulations, he added. What's more, a vendor credentialing firm can help a provider such as the University of Chicago keep on top of the thousands of individuals who are on the government's list of vendors who have been prohibited from doing business in Medicare institutions.

"There has been a lot of pushback [from vendors]," admitted Carey. "And I know there's a lot of expenses [associated with credentialing]." Carey conceded that vendors will probably pass on these additional costs to their customers.

Vendor credentialing firm

A former medical device sales rep himself, Peter Sheehan admitted "it is alarming where a vendor rep can go in a hospital." The need for some kind of controls has been clear for some time, he said. He decided to found REPtrax in 2005 because he sensed a market opportunity. "I saw the writing on the wall - that hospitals were creating their own [vendor-credentialing] systems. If there weren't third-party credentialing, you would have a per-hospital charge. You'd be negotiating with each hospital you call on." The Lewisville, Texas-based company has a seven-year, sole source agreement with MedAssets, and a three-year agreement with Consorta, he said.

Sheehan had a sympathetic audience among IMDA members, because the REPtrax model gives the sales rep access to any REPtrax hospital or IDN for just one fee. In addition, the company does not provide financial analyses of vendors, nor does it collect personal information, such as a sales rep's social security number or driver's license number.

Distributor's perspective

Meanwhile, representing the voice of specialty distributors, Tri-anim CEO Bob Byers argued in favor of a passport-type system for sales reps. Such a system would ensure that after meeting one universally accepted set of credentialing requirements, the rep would have access to any hospital in the country. Such a system would promote patient safety without damaging specialty distributors financially, he said.

The lack of a universal credentialing system is extremely costly, and it may drive some specialty distributors out of business, said Byers. "Yes, eventually you can pass those costs on, but you have to survive long enough to be able to do that." Ironically, then, the healthcare system's attempts to ensure patient safety through credentialing may backfire, as the companies that specialize in introducing innovative technology to the market - and then training clinicians how to use them - are priced out of the market, he said.

Byers urged all parties to use "common sense" on the credentialing issue. Reps are well-groomed and educated on HIPAA and infection control, he pointed out. In fact, they present less of a threat to patient safety than many visitors, he said. Yes, some standards should be in place for reps who call on the OR and patient care areas, he said. "But reps should only have to meet the [same] level [of requirements] as anyone else in the OR."

What's next

Following the panel discussion, IMDA President Shawn Walker of Bay State Anesthesia facilitated a brainstorming session on the vendor credentialing issue among IMDA members. Of critical importance is how the Joint Commission ultimately categorizes salespeople, she said. That's because the category into which an individual rep is placed will, in all likelihood, determine the requirements he or she will have to meet in order to be credentialed. Presumably, reps who are in relatively close contact with patients, such as those calling on med/surg floors or the OR, will have to meet stricter guidelines than those who call on the materials management staff. But simply lumping reps into two categories - those who call on patient-care areas and those who do not - may be too broad, said Walker and others at the brainstorming session.

AdvaMed, an association of medical products manufacturers, has already asked the Joint Commission to develop definitions of "healthcare industry representatives" that would reflect their diversity, and develop specific credentialing requirements relevant to the rep's role. To view a copy of the association's Sept. 26, letter to Laura Smith, go to http://www.advamed.org/NR/rdonlyres/D13CA862-1836-45DF-891F-CC009B5EAC99/0/AdvaMedcommentsonHCIRCredentialing0926074.pdf.)

Ed Boracchia wins IMDA's Ernie Douglass Award

Oridion receives Manufacturers Award

OAK BROOK, ILL-Ed Boracchia - CEO of Boracchia + Associates, 26-year member of IMDA, and former president of the association - was the recipient of the prestigious Ernie Douglass Award. The award was presented by former IMDA president and Award recipient Dave Campbell at the recent Annual Conference.

The award was established in 1994 in the memory of Ernie Douglass, a founder of IMDA in 1978, and the association's third president. It recognizes a person in the healthcare industry who exhibits support and encouragement of associates, a willingness to share his or her business and distribution knowledge, and professional salesmanship and ethics in business.

"I first met Ed Boracchia when I joined IMDA in 1991," said Campbell. "I felt a bit unsure of myself as I joined a group of fairly successful business owners in this industry. I'm sure many of our new members feel the same way today. But Ed was not one to hang back from making new friends, and I think his ever-present smile was part of what made getting to know each other just that much easier."

Meanwhile, Oridion Capnography received IMDA's Manufacturers Partnership Award in recognition of its outstanding relationships with specialty sales and marketing organizations. Oridion is an Israeli company with U.S. offices in Needham, Mass. Founded in 1987, the company developed a measuring technology for capnography, which is the graphical depiction of the amount of carbon dioxide being exhaled by a patient.

The IMDA award recognizes a vendor that offers exceptional clinical and sales support; communicates openly, frequently and honestly; responds promptly to questions, suggestions and problems; aggressively and creatively markets its products through such vehicles as advertising, trade shows, promotions and direct mail; and actively contributes to helping IMDA members increase revenues on its product lines.

"Oridion's clinical support has been excellent," said Tom Birmingham of Bay State Anesthesia, who created the Manufacturers Partnership Award. "Their clinical sales specialists are very business-savvy and dedicated to each region." Oridion has high-quality support people in place, and it maintains "great presence" at national shows, he added. It also publishes "excellent literature, CEU packages and educational material for the customer."

This year was the second year that IMDA presented the Manufacturers Partnership Award. Last year's recipient was Vidacare, the San Antonio, Texas-based manufacturer of the EZ-IO® intraosseous drug-delivery system.