Healthcare Management News & Features
Case Study: Using External Peer Review to Meet OPPE Standards
This document will help you understand how one Florida hospital has developed an external peer review-based Ongoing Professional Practice Evaluations (OPPE) program, which is rapidly becoming a Best Practice for many leading hospitals and ASCs.
External Peer Review As A Risk Minimization Strategy: A Legal Brief
This document is a great tool to share with your hospital colleagues as it highlights current issues related to: changes in state statutes and confidentiality of peer review, triggers for external peer review, compliance with FPPE and OPPE standards, and responding to internal barriers related to peer review.
When are Antibiotics for Lyme Disease Medically Necessary?
As good weather brings people outdoors and into the woods, it also exposes them to tick bites that can result in Lyme disease, one of the fastest growing infectious diseases in the United States. Read the new IDSA guidelines concerning the use of antibiotics for treating Lyme Disease, and what the current recommendations for diagnosis and care require.
Learn How Patients can Meet the Criteria for Insulin Pump Therapy
While many health plan insurers will pay for patients with type 1 diabetes mellitus to have an insulin pump, the criteria for approval is not always clear.
Off-Label Avastin Use For Wet Macular Degeneration
The Food and Drug Administration (FDA) has only approved Avastin for cancer of the colon and lungs. In off-label use, however, Avastin is proving itself as a “miracle drug” that’s currently used by some doctors to treat other cancers, including breast, prostate, renal cell, head and neck, pancreatic, ovarian and hepatocellular.
Understanding Focused and Ongoing Professional Practice Evaluations
The 2007 Joint Commission (JCAHO) standards strengthen and extend the peer-review process. They call for hospitals to make unbiased credentialing and privileging decisions based on physician performance. Hospitals evaluate that performance using two types of professional practice evaluations — focused and ongoing.
Free Guide: How to Apply the Joint Commission Standards to Hospital Peer Review
The medical staff standards of The Joint Commission have strengthened the peer review process, with explicit requirements for focused and ongoing professional practice evaluations. Download our free guide and learn how these standards affect your credentialing, privileging and peer review committee operations.
Recent Independent Medical Review Blog Postings
Presidential Candidates On Healthcare
"The next president of the United States will confront major health policy decisions that will affect the lives of all Americans. With the first of the presidential caucuses and primaries only six months away, the pressure is on for the candidates to provide Americans with their plans to improve the nation's health care system -- and rightfully so. Despite spending over $2 trillion a year on health care -- 18% of the U.S. GDP and twice as much as any other nation -- the United States ranks only 45th in life expectancy and 37th in a World Health Organization study on the performance of national health systems. 1,2 The U.S. federal government currently spends more on health care than on Social Security and national defense combined, the next most expensive items, but Americans get the right treatment only 55% of the time.
Posted 1.14.08
The Right Vision of Healthcare
Yaron Brook, managing director of BH Equity Research and executive director of the Ayn Rand Institute, has a op-ed this week in Forbes by the above title. He brings up several interesting questions and skewers both political parties approaches to health care reform.
Posted 1.9.08
Software Diagnosis and Quality
According to a 2003 study published in The Journal of the American Medical Association, at least one in 12 patients who die were diagnosed incorrectly. While doctors face some hard to diagnose cases, will turning to technology to bridge this gap make a difference in these numbers, or healthcare quality? Younger doctors are more comfortable with technology and are ready to rely on it. As the doctors from the baby boom retire, will automated diagnosis become more the rage?
Posted 1.10.08


