Independent Medical Peer Review

BusinessManagement

  • Author Andy Knudsen
  • Published April 2, 2011
  • Word count 383

A independent medical peer review uses historical data analysis as a basis for a strong foundation of pre-certification analysis. This is an area of the review process that aids the organization in rapid determination of the upcoming patient needs upon diagnosis and allows for the standardization of quality care to be applied to each patient that fits the historical profile. While each case of new disease presents itself as a single occurrence in the individual patient's life, it is unlikely that it is an unique occurrence in the historical records of any substantial health care organization. Therefore it is likely that established protocols exists for the treatment of a particular condition, a independent medical peer review can assure this is the case.

In addition to the standards of care that are well established with in a particular organization, needs analysis and case assessment are used to compare the quality of care to the nationwide standards so that regional discrepancies are eliminated. This is one of the main values of independent medical peer review. If there is a new standard protocol of treatment for a particular disease or condition, it becomes apparent in the medical records review whether or not these state-of-the-art standards are being followed. Sometimes an organization is completely unaware that certain standards have changed or that they have been improved. This may be because of lack of sufficient research staff, latency in training protocols, or simply because certain treatments have always been done in a certain way by an organization and there is a empirical inertia that slows or inhibits modernization and improvement through change. A independent medical peer review can help identify and cope with these issues.

A independent medical peer review will discover problematic areas and highlight suggestions for improvements which quite frequently are beyond the bounds of the knowledge base of any particular organization. Even when there is sufficient knowledge in the individual staff members, there is often resistance to change that is an individual's idea even if they are a strong change agent. For improvement to be manifested in an organization it needs to be part of an overall plan of quality of care improvement that is mandated to all of the organizational staff as the accepted agenda for it to have any chance of being implemented.

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