Rep prep misstep?

CHICAGO — Call it irony, incompetence or idiocy.

We can send a high-tech dune buggy to Mars, track its maneuverings and actually drive it around via remote control from hundreds of thousands of miles away. But we struggle to track which sales rep or even pizza guy roams through the operating room back hallways.

Whether you call it vendor credentialing, supplier credentialing or the more politically correct supplier management, the process of validating and verifying authentic sales reps has reached a boiling — and possibly turning — point rather quickly.

During a panel discussion on supplier credentialing here at the Health Industry Representatives Association’s annual conference independent reps in attendance voiced their concerns about the matter. Tensions were palpable. And with good reason.

Why? For one, economics. It costs considerable coinage to manage a supplier credentialing program, as well as to "be managed" by one. Manufacturer-direct sales reps tend to work for companies with a seven-digit minimum bank account that more than covers this cost of doing business. The independent reps under contract to manufacturers? They tend to foot their own bills.

Still, with emphases on HIPAA, medical errors and patient safety, it’s hard to argue against the need for supplier credentialing. Panelist Rhett Suhre, director, HCIR Credentialing, Abbott Laboratories, deftly noted "It just takes one person to do something dumb…" Suhre, one of the architects trying to forge direction, order and structure from the emotional uncertainty, chaotic frustration many companies have felt and shoot-from-the-hip responses, is spot-on. Too much is at risk and at stake to do nothing.

Suhre is part of a coalition of professionals and companies trying to get in front of this issue before the government feels the itch to get involved. And rightly so. Some in the HIRA audience actually raised the prospect of Congressional oversight.

Apparently, healthcare organizations do not apply supplier credentialing rules universally. The direct and independent sales rep, for example, must jump through costly hoops to get into the inner sanctums of hospitals, but the pizza guy or third-party courier services rep, etc., may get a free pass. Senators on the Judiciary committee subcommittee stirring about antitrust and restraint-of-trade claims might salivate at the opportunity this charge brings.

Certainly, supplier credentialing isn’t a "new" issue, but much of the industry is playing catch-up to keep up. Give the players props in this sector of the Wild West, however, as we’ve only been nosing around this for the last six years or so and really turned up the heat within the last 24 months. Debate about bar coding and even supply data standards is comfortably nestled well into its third decade.

The supplier credentialing coalition holds meetings and workshops to craft best practices, processes, standards and tools, all of which are noteworthy and needed goals.

One of its primary aims is to develop standardized processes, such as 25 criteria that must be included in the credentialing database. Anything beyond that would be customized "one-offs" determined by each facility.

Another goal seeks to delineate the blurred lines between supply chain, clinical services and risk management. At the HIRA meeting one independent rep eloquently wrist-slapped the industry for tacitly accepting fuzzy justifications for supplier credentialing that claim it will lead to "better clinical outcomes." Perform specific clinical studies to support those persuasive arguments before issuing them, he saliently urged. After all, if "show me the data" works for doctors and surgeons, it also should suffice for sales reps.

What’s also needed is some type of independent regulatory body, independent of government, to oversee supplier credentialing practices. Three credit reporting bureaus manage how consumers invest in the economy through credit. Because they are prone to errors, they need oversight to protect people unwilling to pay cash for everything.

More than just a Healthcare Supplier Credentialing Association (because the acronym already is taken), this regulatory body must stress and strive for accuracy, compliance and ethical behavior. If this represents the way we have to do business then we’d better do it right.