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When done correctly, peer review is an important process that helps hospitals and their doctors to ensure a consistent and high quality patient care. Hospitals can identify physicians at risk, physicians can help improve the quality of care for patients. Why is this process so difficult? It's simple - the hospital's policy, the economic advantage and personalities. The current point system for medical examination, created by Congress in 1986 through HCQI legislation, intended to promote greater quality health care to the patient. Unfortunately, Congress did not foresee that hospital peer review actually puts physicians in an environment where political conflicts, economic and personality can make the process inefficient. Neither hospitals are expected to sanction doctors speak on behalf of patients regarding the quality of care concerns. In the hospital setting, peer review is considered an unpleasant task that is only one element of action for a busy medical staff and is easily pushed to the bottom of the list of priorities. Often, just not done. Why? The medical peer review committees or quality management are often in conflict of interest. They compete for the same limited geographical group of patients and professional recognition in a very narrow specialty. There may also be personality conflicts with the medical review, or pressure from their hospitals to not seriously consider a physician colleague who has the stature in the medical community. Tightly knit social relationships and professionals are in a hospital environment can lead to bias and reluctance to judge partners. This resistance tends to lead to unusually long delays in resolving critical issues of quality management. For the time is really a critical situation dealt with, the costs and risks to a hospital or group can be catastrophic. Reaction A breakdown in the system of hospital quality management can be very harmful. peer review may not be enough (and have) negative consequences for hospitals and hospital groups, such as lawsuits or negative publicity or high profile or multi-million dollar fines and Management shock or loss of investor confidence Damage or careers of physicians and practices or in the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) sanctions and the loss of accreditation review or state and federal agencies and other public organizations. These negative events, together with increasing consumer frustration with the health system, makes it increasingly imperative that hospitals pay much attention to quality management and adopt best practices wherever possible. Peer Review as a Risk Management Tool A peer review process well executed can avoid negative events, using best practices in risk management. The earlier a doctor performance problem is detected and treated, reducing costs and negative consequences for the hospital and doctor. Building effective peer review of scientific evidence and adherence to the intent of the law - to improve the quality of patient care - helping you to discover, highlight and address problems as quickly and efficiently. Issues relating to domestic policy, competence and personality conflicts should be considered when setting up a peer review committee. The minority interest in the Peer Review process more effective quality management is to use a "neutral" was also part of the commission itself of hospital peer review. This neutral party can review sensitive cases where there is a potential conflict of interest. Hospitals with the need for a case review would often have made the affiliated hospitals have sought or "as" specialists through personal connections. While this is an effective method to solve the problem, which has its own set of challenges: o How to quickly locate the right specialist? Or how do you convince to take time for peer review? O How long must you wait for it? Unless you have a well-developed and previous agreements with affiliates or physicians to conduct peer review can be costly and time consuming to fix it whenever necessary. IRO: a cost effective solution for the Hospital Peer Review Many hospitals today are turning to Independent Review Organizations (IRO) to assist in fixing the peer review process. An IRO serves as an objective third party can provide hospital peer reviews based on medical evidence and improve the fairness of the process for both doctors and the hospital. An IRO can match physicians with the right expertise to review sensitive cases effectively and reach an objective determination. Reviews are conducted by board-certified physicians in active practice, which is usually located in a different state that the physician being reviewed. Hospitals only pay for the medical examination time at hourly rates of default. Because these experts are already on board, the reviews can be completed in less time and at significantly lower cost. Peer reviews are performed in a standard format, and the typical turnaround time is less than 21 days. From IRO review thousands of cases every year, for instance, costs are kept to a minimum revision. An IRO can provide peer review of high priority and timely consideration it deserves - no affect hospital staff or to tarnish the reputation of a hospital. Using an IRO for objective peer review can be one of the best solutions to help hospitals back to the intent of the law - improving the quality of care for patients. An IRO may also help reduce costs, avoid costly litigation, improve the hospital's reputation and protect JCAHO certification. Review of the Best Practices In order to ensure an outcome based on the evidence for peer review, hospitals must consider the nine-step process: 1. Develop a culture of accountability within the hospital. 2. Ensure that the review process is well defined, understood, accepted and respected by all. 3. Beware of "sentinel events." Take the patterns of recurring problems or gathering attention of management in a timely manner. 4. Make sure that the questions asked during the process are accurate, and that responses are accurate and in particular the difficult issues associated with foundations and guidelines. 5. Make sure that every case of peer review is reviewed by a "how" specialist who is impartial and has no potential for conflict of interest to express an opinion. 6. Ensure that the peer review committee meets monthly and that the cases and the responses are distributed, reviewed and answered in a timely manner. 7. Make sure there is a review of each case after the entry medical issue has been received. 8. As far as possible, conduct all reviews in a non-accusatory and professional format. 9. Routinely send their most sensitive cases of peer review to the Independent Review Organization. Choosing the Right IRO IRO Selecting the right partner for the review of hospital peer can be as confusing as the process itself. Here are some simple questions to ask in the selection process: 1. URAC IRO Is it accredited? - There are dozens of companies offering health screening services. There are only a few that are actually accredited by the American Accreditation HealthCare Commission, also known as URAC. When you select an IRO with URAC accreditation, the hospital partner with standards-based organization can provide the quality and objectivity to the process of peer review. 2. What types of doctors on the staff of the IRO? - It is very important to work with an IRO to have doctors on staff trained to make quick decisions, which are certified by the board and still in active practice. 3. How deep is the specialty panel IRO? - The IRO considered must be able to provide the specialists needed in a time of | Terms |. Not only doctors should be in the same specialty, but also of the same type of institution. A heart specialist from Los Angeles can not be the doctor the right to review a case involving a hospital from rural Illinois. 4. What are the standard turn-around time? - The IRO selected should have a history of turning around quickly and accurately comments. Find out what the average response times are and what process of the IRO provides for expedited review. A standard of 21 days or less for hospital peer review should be the minimum. 5. How accessible are medical IRO? - IRO Many offer basic | Peer review services |. The best agents charged with the review, however, are really acting as partners to the commission of hospital peer review and be fully accessible to physicians under review. By becoming a part of the process, the IRO can actually act as neutral third parties and help maintain relationships between all parts intact. More information about the IRO can be found on the website of URAC in http://www.urac.org. About AllMed Healthcare Management Inc. Founded in 1995, AllMed is a URAC accredited Independent Review Organization (IRO), providing peer review services to groups leading hospitals and medical facilities throughout the country. AllMed also provides independent medical reviews for insurance payers, providers, TPAs and claims managers. AllMed growing customer base includes leading companies such as Educator's Mutual Life, IMS Managed Care, Tenet Healthcare Corporation, HealthGuard, several Blue Cross Blue Shield, TriWest Healthcare Alliance, Allianz and many other important health payers.

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