Has OPPE made a difference?
It is not uncommon to put into place something that we hope will improve our lives. Maybe it is a new appliance that we think will save us time. Perhaps it is a new smartphone application (my kids call these "apps") that will help us find something more easily. Although we often invest money or time into these efforts, we often don’t reflect on whether they really made a difference.
I mention this because we are approaching the four-year anniversary of the Joint Commission’s OPPE requirements. Has OPPE made a difference in improving our approach to peer review and individual physician performance? To answer this we need to look at what difference was OPPE supposed to make.
I believe that OPPE is based on two fundamental concepts:
1) If we have more timely review of data, we can do a better job of indentifying physician performance issues sooner and address them more effectively
2) If we move away from individual case review to the use of aggregate data (e.g. rates), we increase the fairness of physician performance evaluation by factoring in the volume of care provided and comparison with internal and external benchmarks
Whether OPPE has made a difference in your organization depends on two factors:
1) What you put into it
2) What you want to get out of it
What did you put into OPPE in the last four years? Did you put together a paper profile with a minimal number of measures and stick it in a physician file for the department chair to glance at and for the Joint Commission surveyor to give your credit for? Or did you use the OPPE standard to drive the peer review program to acquire the kind of aggregate data that can give real insight into physician performance?
What did you want to get out of OPPE? Is it simply to pass your accreditation survey or did you create systematic and timely feedback to your physicians that both recognizes excellence and drives self improvement and policies for your physician leaders to evaluate and manage physician performance in a timely manner?
I believe the answer to whether the Joint Commission OPPE standard has made a difference is not so much as to whether the Joint Commission has succeeded or failed, but rather have we used this opportunity as an industry to invest in more effective methods of physician performance evaluation.
Robert Marder, MD, CMSL, vice president of The Greeley Company, a division of HCPro, Inc. in Danvers, MA contributed this article.