Articles

A Cut Too Deep

By exporting a peer review case to an independent review organization, a hospital ensures patient safety and best practices.

Doctors Pass-Along Prescription Deadly

A hospital misses an opportunity for a doctor's peer review, costing a man his life.

Shortcomings of Internal Peer Review

It's no secret that hospital peer review is a broken process. Improving the quality of care for patients by protecting them from substandard medical care is an admirable goal and one that doctors and hospital risk managers agree on.

New Standards Increase Conflict of Interest Concern

The likelihood of conflict-of-interest issues are increasing due to the Joint Commission's new and ardent standards for hospital credentialing and physician privileging.

Best Practice: Credentialing Low-Volume Providers

If a physician in your hospital group does not meet the clinical activity required for re-credentialing, how do you determine his or her competence before assigning privileges?

Improperly Maintained Equipment Caused Overdose

An external peer review finds a hospital at fault for failing to update medical equipment.

External Peer Review Heads off Litigation

After internal politics and a lawsuit threat prompted conduct external peer review, a hospital hires an independent review organization to sort out and establish the red flags of the case.

Defining Peer Review

Learn to differentiate between peer review, independent peer review and credentialing peer review.

Hospital Peer Review Survey Results

After conducting a peer review survey, AllMed finds that hospitals and medical groups are proactive in their peer review through utilization of an independent review organization.

Hospital Stays - When to Pay for the Last Day

Payers should understand that eliminating coverage of a patient's last day of a hospital stay will not necessarily result in cost reductions.

IROs and the Hospital Peer Review Process

Using an independent review organization as part of the peer review process is not focused on finding and punishing "bad" doctors. Rather, an IRO takes a systematic approach to determine the reasons for sentinel events and a broader range of queries.

Move Toward Best Practices for Hospital Peer Review

An independent review organization can quickly help hospital litigation teams and quality managers understand litigation cases and provide outside insight into a peer review case.

Outsource Hospital Peer Review to an Independent Review Organization

In order to conduct efficient peer reviews and avoid conflicts of interests, outsourcing hospital peer review is the best practice for hospitals. Using a third party, hospitals receive an objective, non-conflicted decision and fast turn around time.

Removing Conflicts of Interest in Hospital Peer Reviews

In terms of satisfactory outcomes, it´s widely known that medical peer review inside hospitals and medical groups is at best complex and at worst conflictive. Outsourcing to a third-party IRO immediately removes any conflict of interest for a hospital and speeds up case resolution. A good reputable independent review organization can offer a panel of specialists in all specialty and sub-specialty areas, as well as a group of actively practicing, board-certified and licensed doctors.

Case Study: Chief of Surgery Shifts Risky Cases

By exporting a peer review case enveloped by conflicts of interest, a hospital reveals a chief surgeon's unfair practices.

Best Practice Case Study: Systematic External Peer Reviews

The method of proactively and systematically reviewing cases both internally and externally (when needed) is becoming a Best Practice with leading hospitals who are committed to establishing higher levels of practitioner performance, transparency and accountability.

Understanding Focused and Ongoing Professional Practice Evaluations

Learn what the Joint Commission's new standards on the peer-review process mean for hospitals and physicians, as well as the difference between focused professional practice evaluation and ongoing professional practice evaluation.

Implantable Cardioverter-Defibrillators: Controversy and Coverage

Now that appropriate use of ICDs is undergoing increased scrutiny by government agencies and by insurers, adherence to ICD placement guidelines is especially crucial. This also makes objective review of these cases more important than ever before. Payer organizations are continuing to have issues with the medically necessity of ICD placement, situations in which an ICD placement does not fall under current guidelines and in areas that require further investigation. This includes over-utilization of ICDs as the primary prevention for patients with a high risk of sudden cardiac death.

AllMed Announces PeerScore Solutions

Customized services meet or exceed The Joint Commission’s OPPE and FPPE standards

AllMed Announces PeerScore Solutions

Customized services meet or exceed The Joint Commission’s OPPE and FPPE standards