Vendor Compliance

Continuing with the theme of 2009 in Review, we can’t overlook the ongoing conversation about standards in vendor credentialing and compliance requirements.   Are there standards already?   Are standards coming?    Should there be standards?   

Going into 2009, AORN, ACS, the CDC and others all had existing statements that could be applicable to clinical healthcare reps.    HHS OIG Deficit Reduction Act sanction clearance requirements apply to the vendor company and its principals. 

But the greatest dialogue centered on the healthcare industry rep in the field.   As the tangible face of the vendor credentialing experience, the industry spent the year most concerned about what was appropriate for the HCIR.  

At the March 2009 AORN Congress, eleven industry organizations, representing clinical groups and supplier interests, released joint best practices recommendations for credentialing clinical healthcare industy reps.    It was a start, but it was clearly labeled as limited in scope.   It didn’t encompass the behaviors and requirements of industry reps outside clinical areas (e.g., gift policies and sanction lists), nor did it touch the credentials of the vendor companies(e.g., sanction lists and financial solvency).

The industry craved more clarity, and the discussion about standards frequently revolved around the Joint Commission.   For two years, every comment the Joint Commission made about HCIRs was examined for relevance and impact.  

Finally in April 2009, the speculation that ”Joint Commission standards are coming” was answered by the Joint Commission’s statement declining to issue standards that specifically address health care industry vendor representatives, but still pointing to several of its own guidelines as applicable.

Still common practices are emerging that are gaining ground as standards.  

1.  Credentials and requirements align with risk.   

Vendormate’s recommendation, and most hospitals agree, is that credentials for individuals should reflect their role.   That is, sales reps that do not access procedural or patient areas do not need to meet the same requirements for training and immunization.    Credentials and requirements should reflect risk and be adjusted accordingly.

2.  The vendor company is distinct from the vendor rep.  

Requirements such as liability insurance and Business Associate Agreements are between the contracting entities — the vendor company and the health system — not between the rep and the materials manager.   While a rep may hold responsibility for providing this information as part of the account relationship, a rep should never be required to change the nature of the business relationship as part of the rep-level credentialing process.   

3.  Rep privacy must be protected.    

The rep’s privacy rights have to be balanced against the healthcare system’s need to document and verify.   Driver’s licenses and SSNs are not part of the default data set.     Reps are routinely reminded to black out that type of information from any document they share.

Yet even as standards for are being debated, the fundamental question of who is a vendor? is still debated.   Is it the company selling the good or service?   Is it the sales rep?  Is it the field service and support rep?

With this in mind, here’s a preview of two of our predications for 2010 and beyond.   First, increasing attention will be paid to the credentials and access of other special populations — visitors, volunteers, and non-licensed contractors.   Second, the uncertain economic climate will further press healthcare systems to measure the risks posed to their operations by their suppliers’ solvency and operations.   More traditional supply chain financial and operational monitoring is coming.