“You must undergo accreditation.” In the past, those words might have made even the most stalwart health care executive quake, and to a certain extent, they still do. But the National Committee for Quality Assurance has created a new online tool to make the accreditation process a little bit easier for everyone involved.
The days of surveyors locking themselves in a health plan's conference room may soon be a thing of the past with the launch this month of the Interactive Survey System (ISS), a Web-based tool that guides participants through the accreditation process. The ISS consists of a survey tool, self-evaluation forms that provide feedback to applicants, and a document library.
The new process is not just more efficient, it is also expected to help organizations and individuals make improvements more quickly since they won't have to wait months for feedback.
There are three objectives for use of the new NCQA tool. They are:
- To allow the transfer of electronic documents. NCQA review can take place offsite.
- To give organizations the ability to evaluate themselves. Ann Carson, assistant vice president for product development at NCQA, says this ability "reduces the surprise factor that organizations may experience — especially new organizations that are undergoing accreditation for the first time."
- To reduce the paper volume. "Aggregate data review required a lot of work to compile all those paper files. Now, the process is electronic. It gives the NCQA an easier way to analyze the data that has been collected."
The switch to the ISS affects essentially all of the NCQA's programs, including its core accreditation and certification programs. Survey participants will find the following features online:
- A document library, which helps organizations manage, update, and track changes to the potentially hundreds of documents that may be submitted as supporting materials for a survey;
- A private notes section that is off-limits to NCQA surveyors, where an organization's staff can communicate with one another about survey matters; and
- A "results" function, which shows preliminary scores.
Carson says that applicants may find the document library most useful. "The results section helps applicants prepare and get a sense of how they're doing, but the document library is where applicants build their case for accreditation. In the end, it's the submission of those documents and review of the documents by NCQA that let's us determine accreditation," says Carson.
Question of privacy
When an applicant uses the survey tool, the answers and corresponding documentation are uploaded onto the NCQA's servers. When the ISS tool was tested, some health plans were reticent to allow potentially detrimental documents out of their hands. There was also concern that poor scoring might affect how the NCQA would view the final submission.
Sensitive to plans' concerns, as part of the licensing agreement, the NCQA promises not to view any materials prior to the start of the survey.
"Organizations told us up front that they would not be comfortable with this process if the data were reviewable prior to final submission," says Carson.
Dennis Roy, national quality director at Cigna HealthCare, applauds the NCQA's efforts. "It is probably one of the best things that the NCQA has come up with for the managed care industry," he says. "It's going to make the accreditation process less burdensome on the health plan. It's a huge improvement from the old days. I can remember having to prepare all of this paper. You could spend two to three weeks at a copier just to prepare the paperwork." Roy estimates the new tool would cut "a good 20 percent of time in preparation — you don't have to organize all the binders and papers. It would reduce the amount of paperwork activity."
That sentiment seems to be common, based on survey data collected from early ISS users who have given it an overwhelmingly positive response, with 61 percent rating their experience as "excellent" or "very good" and the remaining users rating it "good" or "fair."
"When accreditation started a dozen or so years ago, it spawned a whole new cottage industry," says Carson. "And undergoing accreditation became an end, rather than a means." So the ISS was created with the goal to develop a new process of accreditation, with the belief that the system would eventually follow suit.
"What we really wanted to do was promote quality improvement through accreditation."
The NCQA is quick to point out that the ISS will not take the place of an actual visit. The full evaluation will still include a visit by an NCQA survey team. Following the initial offsite portion of the evaluation (during which the NCQA will review an organization's completed survey), reviewers will typically spend one to two days validating key information and conducting interviews with the staff.
Ready, set, launch
The ISS tool was scheduled to begin general use on July 1, according to NCQA spokesman Brian Schilling. The ISS tool has been undergoing review and comment to allow early adopters to become familiar with it. NCQA made the tool available in July 2003, in order to alert organizations that might need to re-apply for certification or new organizations considering certification.
"We actually allowed some organizations to reschedule their certification for after July 1, so long as the change did not cause their current accreditation status to lapse," says Carson.
Use of the new ISS tool will be mandatory, according to NCQA. "For everyone to reap the benefit, we had to make this mandatory," says Carson.
For more information about the ISS and the online demonstration tool, visit http://www.ncqa.org/Programs/ISS/Overview.htm.