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4. A Response
Pages 22-26

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From page 22...
... PROGRAMMATIC CONSIDERATIONS We do, however, disagree with some of the programmatic activities recommended in the IOM's report. For example, we believe that before considering recommendations regarding the complete elimination of utilization review as a component of Peer Review Organization (PRO)
From page 23...
... Data analysis will be an important adjunct tO, rather than a substitute for, clinical judgment. Improved data and more sophisticated data analysis will be useful to quality assurance activities.
From page 24...
... AMERICAN MEDICAL ASSOCIATION (AMA) GUIDELINES FOR QUALITY ASSURANCE Because of our deep commitment to improving the quality of medical care, the AMA has developed a set of guidelines for quality assurance that should be included in any medical peer review system.
From page 25...
... Although data analysis and outcomes assessment will be important, data analysis will never substitute for clinical judgment or for medical peer review. Physicians have long played an active role in efforts to improve the quality of medical care, and future efforts to improve quality assurance must involve physicians and physician organizations in every aspect of the planning and implementation of quality assurance systems.
From page 26...
... Pp. 18-22 in Medicare: New Directions in Quality Assurance.


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