How Telehealth and Decentralized Care Models Are Exposing Weaknesses in Provider Verification Processes

Guest Contributor Karthik Achari, founder of PepMD, explores why traditional provider verification processes are struggling to keep pace with the rapid expansion of telehealth and decentralized care models.

Today’s patients will probably check online ratings before making an appointment with a healthcare professional. They’ll look at factors such as how friendly the staff is and how easy it is to make an appointment.

But patients probably won’t dig into a doctor’s background to assess the qualifications and credentials demanded by the healthcare industry. Those types of issues aren’t questioned because of an underlying assumption in modern medicine that providers have already done the work. Most patients simply trust that the person who will treat them is who they say they are, knows what they’re supposed to know, and is operating within the scope they’re permitted to operate in.

Verification is the silent infrastructure that lets every other clinical encounter happen. But as telehealth and decentralized care models have increased the speed and scale of modern healthcare, verification systems become more difficult to maintain.

For patients, the potential for breakdown in the verification infrastructure serves as a warning. For those who support the medical industry with patient monitoring and other telehealth solutions, it illustrates the need for innovations that can keep patients safe as healthcare models continue to shift.

How decentralization makes it difficult to maintain a defensible system

In a hospital setting, the verification infrastructure needed to keep patients safe is layered. The state board confirms licensure, the hospital privileging committee confirms specialty training and competency, and the payer confirms network eligibility.

Each gatekeeper is checking different things. Each one is a partial check that adds up to a defensible system. The patient walking into an emergency department doesn’t think about any of this, which is the point. The verification work happens upstream so that the clinical encounter can focus on the care.

Telehealth and the decentralization it has empowered break the assumptions on which verification has been built. The traditional system assumed providers practiced in physical locations, were privileged at named institutions, had a hospital or health system standing behind them, and operated within state lines that aligned with their license.

In a remote care environment, none of those assumptions hold cleanly. A provider can be licensed in 12 states, contracted with three telehealth platforms, prescribing to patients in jurisdictions they’ve never set foot in, with no hospital or health system in the chain of accountability. The patient has no obvious way to verify any of the information that ensures they are receiving quality care. A lot of the time, the platform doesn’t either.

The shift in scale occurring as care networks become decentralized is a compounding problem. A telehealth platform onboarding a thousand providers a quarter isn’t running primary source verification the way a hospital privileging committee would. A direct-to-consumer wellness clinic isn’t credentialing against specialty boards.

The infrastructure that previously caught gaps is either absent or running at a fraction of the rigor. CAQH and NCQA accreditation help on the institutional side, but they were designed for traditional credentialing workflows, not for platform-onboarded providers at decentralized scale. The Federation of State Medical Boards has been pushing interstate compact frameworks to address the licensing question, which is meaningful, but compacts solve where a provider can practice. They don’t solve whether a provider should be practicing a given thing in the first place.

When the verification infrastructure breaks down, the downstream consequences are real, and they don’t surface in a single failure mode. They show up as missed contraindications, scope-of-practice mismatches, treatment outside areas of competency, fraudulent credentials, and adverse events that get attributed to other causes because no one in the chain was checking whether the prescriber should have been treating that condition in the first place. The patient bears the cost of verification failures they have no way of detecting.

How third-party providers can help to modernize credentialing and verification

“Kalorama Information reports that the remote patient monitoring and telehealth market topped $65 billion in 2023, driven by rising demand for more wireless, efficient healthcare operations and expanded in-home patient care.”

The growth in demand for telehealth services has sparked expansion in both the institutional and home segments of the patient monitoring and telehealth markets. According to Kalorama’s Remote Patient Monitoring and Telehealth Markets, 13th Edition, the market, which includes devices, peripherals, software, packaged services, monitoring services, and other applications, surpassed $65 billion in 2023. Kalorama says the demand for “more wireless and streamlined operations both within major health facilities and in-home treatment markets” is a key driver of the industry’s growth.

As providers seek to prevent a breakdown in the verification system, they need to pay close attention to the third-party devices and services they are leveraging to support telehealth. The infrastructure is built upon a technology stack, with the provider serving as just one layer. Other layers include:

• The telehealth platform routing the encounter.
• The pharmacy filling the prescription (which is a layer that increasingly includes compounding pharmacies).
• The remote monitoring devices generating data.
• The third-party labs running tests.
• The AI tools assisting with documentation or decision support.
• The payment processor moving the transaction.

Each of these touches patient care in ways the traditional credentialing model wasn’t built to govern. If you’re going to verify the provider, you need to verify the system the provider is operating within.

A credentialed clinician using an uncredentialed pharmacy with a mislabeled product gets you to the same patient outcome as an uncredentialed clinician. A credentialed clinician using a remote monitoring device with poor data integrity is making decisions on bad inputs. A credentialed clinician using an AI tool that’s hallucinating drug interactions is amplifying their own errors, not correcting them.

The credentialing question can’t stop at the prescriber. It has to extend to the components. This is where private credentialing infrastructure has the strongest opportunity.

The third-party device and service space is too fragmented and moves too fast for state boards or federal regulators to credential individually. Private standards bodies have credentialed analogous infrastructure in other industries. UL did it for electrical devices and ISO does it for laboratory testing. The same logic applies to the components stacking up around modern decentralized care.

To facilitate decentralized care, the verification infrastructure needs to be rebuilt

Telehealth holds great potential for improving patient outcomes by increasing accessibility. But for that potential to be realized, the increased access must connect patients to quality care provided by verified professionals.

Patients should be able to verify their telehealth provider as easily as they can verify a hospital’s accreditation. Right now, they can’t. Most don’t even know what questions to ask. And the silent infrastructure that traditionally kept those patients safe is not as reliable as it once was.

Decentralized care is here to stay. The systems built for institutional medicine aren’t going to scale to meet it without being rebuilt. The verification infrastructure has to evolve at the same pace as the care models it’s meant to govern.

— Karthik Achari is a Clinician and Founder of PepMD, the first private accreditation and credentialing body purpose-built for peptide medicine. A clinician by training, Achari attended Bradley University’s Doctor of Nursing Practice/Family Nurse Practitioner program and built his perspective on healthcare by working with providers to optimize peptide prescribing practices and by operating healthcare businesses. This dual experience has given him a comprehensive understanding of how the system functions in practice, where standards exist, where they fall short, and where critical gaps remain. In 2026, Achari founded PepMD to address the rapid growth of peptide medicine without the infrastructure needed to support it. Modeled in part after established accreditation systems like The Joint Commission, PepMD credentials clinicians, recognizes pharmacies, and authorizes research sites under a single, unified standard. His work focuses on bringing structure, credibility, and oversight to an evolving sector that has outpaced traditional regulatory frameworks.