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Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. [ 1 ] [ 2 ] A discipline-specific process may be referenced accordingly (e.g., physician peer review , nursing peer review ).
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Identify areas where health care providers may need further information and education. Once the main problem areas have been identified (from integrated data, health indicators, qualitative studies, other appropriate studies, and even recommendations from developing country committee members), appropriate systems can be established relatively ...
This approval followed a concurrent review and approval by the Rhode Island Department of Health. CharterCARE Health Partners, created through the affiliation of Roger Williams Medical Center and St. Joseph Health Services of Rhode Island, was formed to preserve and enhance quality health care for the communities they serve. [5]
Global Healthcare Accreditation (GHA) [5] Healthcare Facilities Accreditation Program (HFAP) Healthcare Quality Association on Accreditation (HQAA) Institute for Medical Quality (IMQ) Joint Commission (TJC) National Committee for Quality Assurance (NCQA) National Dialysis Accreditation Commission (NDAC) [6] The Compliance Team, "Exemplary ...
Comparative effectiveness research (CER) is the direct comparison of existing health care interventions to determine which work best for which patients and which pose the greatest benefits and harms. The core question of comparative effectiveness research is which treatment works best, for whom, and under what circumstances. [ 1 ]
"Moderate coffee drinking has been related to health benefits," lead study author Lu Qi, M.D., PhD, interim chair of the Department of Epidemiology at Tulane University, told Fox News Digital.
An independent medical review (IMR) is the process where physicians review medical cases in order to provide claims determinations for health insurance payers, workers compensation insurance payers or disability insurance payers. Peer review also is used in order to define the review of sentinel events in a hospital environment for quality ...