What is Peer Review?

In 1952 the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a United States-based nonprofit organization that accredits more than 21,000 US health care organizations and programs, required hospitals to conduct peer review to retain accreditation.

Peer review is a process in which an identified doctor is reviewed—through oral discussions, patient interviews and supporting documents—and a judgement is made about his or her fitness to practice medicine at a hospital. Despite being mandated by JCAHO, the manner in which peer reviews are conducted, analyzed, and utilized varies widely across institutions. Peer review creates a way to adjudicate and track physicians with a history of medical malpractice payments or adverse actions. Peer review protects patients by identifying physicians who have been convicted of systematic malpractice and/or bad judgement in their practice of medicine. These physicians are typically identified through a hospital’s proprietary peer review system.

One of the biggest challenges of a peer review system is managing all of the data associated with a physician’s case. If these data including testimonies, paperwork and medical records are not managed properly, it can cause an unfair result for the patient or physician.

Case Study

Quest recently worked with a large children’s hospital to help it transition to a more effective peer review document management system. This hospital’s peer review team had a need like most other teams – the need for a system to manage data and documents with reporting capabilities. While seemingly a simple request, the team struggled with an existing system that was slow, didn’t allow for editing, and ultimately didn’t meet their needs. With the help of the hospital’s IT team, a database was constructed to serve as an interim solution. Like most interim solutions, the database was not intended to be used as a system.

As the peer review team set out to find the right solution they found that a lot of vendors required drastic workflow changes. As the peer review process is complex, this was not going to work. And that is when the hospital’s team looked to ChartMaxx, an enterprise content management solution from Quest Diagnostics, for help.

The implementation of the ChartMaxx Peer Review solution started with a proof of concept design and demonstration. This put the Peer Review team’s concerns at ease regarding whether or not the solution could really be customized for this hospital’s unique peer review process.

The solution “go live” was a smooth and successful transition, and user feedback has been incredibly positive. The ChartMaxx Peer Review application brought stability to the peer review process, aides in consistency and standardization of documentation, and is designed to eliminate errors in the process through configurable drop down menus to limit options to only those appropriate for the case or disposition.

Conclusion

As hospitals embrace efforts to improve their practice, they must also look to implement ways to standardize their peer review processes that allow for fair evaluation of individual standards and quality-of-care issues. One of the most important ways to do this is by implementing a system that allows these hospitals to effectively and fairly manage documentation associated with the peer review process.