OPPE for employed physicians: 3 information-sharing best practices
This week, CRC Daily covers OPPE. An organization’s decision to employ physicians may require reexamination of existing information-sharing approaches to promote compliant, confidential, and effective use of performance data. Most medical staffs are rightfully extremely protective of any information about the peer review process. However, to meet the legitimate needs and concerns of all parties—the organized medical staff, the health system employer, and the employed physician—integration must exist to allow some level of formal information sharing between the health system employer and the organized medical staff peer review process while simultaneously guaranteeing that there are no unsanctioned breaches of confidentiality.
The first step is to recognize that peer review protection varies tremendously from one state to another. It is important to know the protections offered, if there are any, and to consult with competent counsel conversant with your state’s peer review protection before proceeding with some peer review sharing arrangement. Following are best practices for information sharing.
Peer review committee membership
One method of achieving cross-linked communication between the medical staff and health system is by designating membership of a health system representative on the peer review committee. A health system representative might be the CEO or designee, such as the chief medical officer (CMO) if the position exists in your organization. Alternatively, it might be the medical director of the employed physician group, if that position exists. The health system representative(s) can serve as ad hoc member(s) of the medical staff peer review body/bodies. This approach creates the linking function necessary for both medical staff and health system employer to have the same information. Depending on your state, linking in this way can be accomplished under the protections afforded to formal peer review bodies in your organization.
Peer review triage body
Another option is to develop a peer review prescreening triage body. Under this scenario, cases are reviewed, triaged, and assigned for closure or further review by either a designated physician reviewer or, better yet, by a small working group that might include the following:
- Physician reviewer
- Designated medical staff officer
- Peer review committee chair
- CMO or the employed physician group medical director
- Administrative support either from the quality department or the medical staff services department
In this fashion, all cases go through a prescreening process, which allows early identification for both the medical staff and the health system employer of any potential concerns or any tracking and trending of ongoing concerns.
Information sharing agreement
An increasingly common mechanism is to establish a formal information-sharing agreement between the hospital medical staff and the employed physician group. These agreements allow the parties to recognize that patient safety and the effectiveness of their credentialing, privileging, and peer review processes can be improved by the appropriate sharing of credentialing, quality improvement, and peer review information related to physicians—in other words, peer review activity. The agreements typically contain language allowing the parties to share physician performance information while still retaining peer review protections afforded by their state.