GAO wants continued monitoring of Joint Commission/JCR firewall

The investigative arm of Congress on Jan. 16 reported that The Joint Commission and its not-for-profit educational and consulting affiliate, Joint Commission Resources (JCR), have made progress in the past several years to prevent improper sharing of facility-specific information, though continued monitoring is warranted.

Three members of Congress, including Representative Pete Stark (D-CA), the new chairman of the Ways and Means Health Subcommittee, requested the GAO report to help determine whether the relationship between The Joint Commission and JCR represents a conflict of interest that affects the accrediting process. The report comes on the heels of a 2004 GAO report that identified flaws in The Joint Commission's hospital accreditation survey process.

"Ensuring the independence of the Joint Commission's accreditation process is vitally important," according to the Government Accountability Office's (GAO) new report. "To prevent the improper sharing of facility-specific information, it would be prudent for the Joint Commission and JCR to continue to assess the firewall and other related mechanisms."

Dennis S. O'Leary, MD, president of The Joint Commission, said in a letter to the GAO that his organization has established an "elaborate firewall and related mechanisms" to minimize possible conflicts of interest. "These mechanisms will continue to be closely monitored and assessed on an ongoing basis to ensure they are operating as intended and refined as needed," O'Leary said in his letter, which was included as an appendix in the GAO report.

The GAO apparently agreed with O'Leary's assessment. "In 1987," the report stated, "the organizations created a firewall-policies designed to establish a barrier between the organizations to prevent improper sharing of this information. For example, the firewall is intended to prevent JCR from sharing the names of hospital clients with the Joint Commission. Beginning in 2003, both organizations began taking steps intended to strengthen this firewall, such as enhancing monitoring of compliance."

In requesting the report, Stark, a longtime critic of The Joint Commission, called into question The Joint Commission's ability to independently accredit organizations while its consulting subsidiary sells products and services intended to assist hospitals meet the self-same accreditation standards.

The new report, Hospital Accreditation: Joint Commission on Accreditation of Healthcare Organizations' Relationship with Its Affiliate, GAO-07-79, is available on the GAO's Web site at http://www.gao.gov/new.items/d0779.pdf.