Benefits and Barriers to Telehealth Credentialing by Proxy

Medical staff credentialing is the time-intensive process of verifying a provider's qualifications before granting privileges within a hospital. This process creates a large administrative barrier for telehealth services, as a large number of providers must be credentialed at each participating originating site within a telehealth network.

Despite the availability of a streamlined telehealth credentialing method called Credentialing by Proxy (CBP), a significant number of hospitals still opt for traditional credentialing. This project seeks to better understand the barriers and benefits to CBP.

This study utilized stratified sampling to recruit nine participants who manage telehealth credentialing. Researchers conducted qualitative interviews using a semistructured interview guide and analysis through the constant comparative method. Length of the credentialing time for providers was also tracked over an 18-month period for 20 originating sites.

The majority of participants experienced uncertainty due to a loss of control over the process with CBP but also acknowledged the benefits of this method. Hospitals utilizing CBP had a significantly shortened credentialing period of 36 days, compared with 103 days with traditional credentialing.

A lack of clarity and a fear of ultimate responsibility or liability were the largest contributors to uncertainty. Factors that decreased uncertainty among originating site hospitals included awareness of regulatory standards for CBP, continuing to check certain credentialing requirements themselves, and adopting a "wait-and-see approach."

This study provided valuable insights into the barriers and benefits of CBP and can be utilized to better address these barriers and increase efficiency within telehealth networks.