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Tip of the week: Physicians need to let go of chart review

Medical Staff Leader Connection, May 14, 2008

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In March, we discussed how using rule, rate, and review indicators can help reduce the amount of time physicians spend on chart review while still providing accurate information regarding physician performance. Using these types of indicators shifts the peer review process away from reviewing individual cases to reviewing more aggregate data, which The Joint Commission is now pushing hospitals to do.

The biggest obstacle to successfully using review, rate, and rule indicators seems to be physician’s reluctance to let go of traditional chart review. Although some physicians may label an indicator as a rule or rate, they still end up reviewing and discussing every case before taking action. This indicates that they misunderstand what it means to designate a performance measure as a review, rule, or rate indicator. Designating an indicator as a review, rule, or rate establishes upfront whether physician chart review will be the first step in evaluating physician performance for that measure.

Using physician chart review for the majority of your physician performance measures where rule and rate indicators are more appropriate is not only inefficient and unfair, but you won’t get the data you need to comply effectively.

This week’s tip was adapted from Measuring Physician Competency: How to Collect, Assess, and Provide Performance Data by Robert Marder, MD; Mark Smith, MD; Marla Smith, MHSA; and Vicky Searcy, CPMSM.

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