Eliminating Conflicts of Interest in Medical Peer Review Cases

It's a well known fact that medical peer reviewsub-specialty areas as well as allied group of board
inside hospital and medical groups is at bestcertified active practice licensed physicians. The
complicated and at worst highly conflictive inindependent review organization can quickly match
terms of its outcomes. Medical peer review isa specific peer review case with a specialty or
inherently a broken process that can lead tosubspecialty from its own panel and assure that
conflicts of interest in many cases. As a result,the specialist that is reviewing the case materials
medical peer review frequently does not get doneis not engaged in any conflict of interest situation.
or gets swept under the rug in hospitalOftentimes panels are made up of specialists
environments.from across the country so it's very easy for an
Why is this conflict of interest so great? MostIRO to select a specialist from a different state
hospitals don't have much depth of knowledge inwhere this is no possibility that there's a conflict.
each specific specialty area, and often, theSecondly, all the cases are done completely
physicians on a peer review panel who are in theanonymously and as a result of this, a peer
best position to evaluate their colleagues arespecialist on an IRO panel is able to maintain
conflicted by either friendship or competitiveanonymity and therefore provide a high level of
forces to make a determination that is notobjectivity in their case review.
completely based upon the medical fact involvedHospitals that are looking to improve the quality
in the case. As a result, conflict of interest is oneof care improve patient's safety and deal with
of the most difficult aspects to overcome whensentinel events and negative outcomes on a more
rendering effective peer reviews in a hospitalexpeditious and efficient basis are using IROs to
environment. Most risk and quality managers inprovide outsourced hospital peer review. We have
the hospital environment understand this fact, anddozens of clients, including hospitals from the
an increasing number of them are turning to anlargest medical groups in the United States, which
independent review organization to provideare now adopting this as a best practice. Most of
hospital peer reviews on an outsourced basis.the hospitals that we initially dealt with for the
Outsourcing to a third party IRO immediatefirst time were in very sensitive situations where
eliminates any the conflict of interest and itthey were already in litigation over a specific issue
speeds up case resolution. Why? First of all, theof a bad outcome related to a physician
independent review organization can deploy amisdiagnosis or mistreatment.
panel of specialists of all specialty and