National Academies Press: OpenBook
« Previous: Review Organizations
Suggested Citation:"Other Organizations." Institute of Medicine. 1990. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: The National Academies Press. doi: 10.17226/1626.
Page 89

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

IMPLEMENTATION AND EVALUATION 89 wishes to set forth several principles for structuring and managing the review process based on earlier IOM reports on utilization management (1989) and quality assurance (1990). 1. Consistent with the recommendations of the IOM report on private-sector utilization management, review criteria should be public with respect to their content and their development process. (This does not require that software and other administrative tools be public.) 2. When criteria are used to assess quality of care, deny payment for specific services, or take similar steps, an appeals process needs to be provided. This process must be clearly described to patients and practitioners and be free from unreasonable complexity, delay, or other barriers. 3. Review organizations should make their review activities as manageable and nonintrusive as possible for both patients and practitioners. These organizations are one contributor to the growing "hassle factor" in medical care. 4. Insofar as possible, review organizations should provide constructive information and feedback to physicians aimed at improving practice rather than punishing missteps. The Forum will need to work with provider groups, HCFA, the PROs, and other organizations to encourage careful development and application of review criteria and other practice evaluation tools. These are not simple or unimportant tasks. Other Organizations Organizations involved with medical informatics and education clearly have a role to play in the dissemination and administration of practice guidelines. Many researchers, practitioners, and institutions are now involved in developing prototype expert systems and other computer support for information retrieval, decisionmaking, and monitoring (Shortliffe, 1987; Greenes and Shortliffe, 1990; Williamson et al., 1989). The relative utility of different approaches, for example, comprehensive nationwide systems (such as PDQ) versus institution- or service- specific systems, should be evaluated. Intended users of information systems may not, in fact, find them useful. The widespread use of information and decision support systems will, however, probably require extensive involvement of commercial enterprises with the capital and expertise to develop, market, and maintain generally usable software, consulting services, and so forth. AHCPR may want to give early consideration to its stance on such commercial developments as they pertain to the guidelines emerging from expert panels.

Next: Updating and Revising »
Clinical Practice Guidelines: Directions for a New Program Get This Book
Buy Paperback | $50.00
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF
  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook,'s online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  6. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  7. ×

    View our suggested citation for this chapter.

    « Back Next »
  8. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!