Release of Provider-Specific Information
WSMA policy states that the methods for collecting and analyzing
provider-specific health care data must adhere to the following
principles:
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The methods for collecting and analyzing provider-specific health care
data shall be disclosed to providers under review and to the public.
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Providers under review and relevant provider organizations shall be
provided with an adequate opportunity to review and respond to proposed
provider-specific health care data interpretations and disclosures prior
to their publication or release.
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Provider-specific health care data shall be valid, accurate, objective,
and used primarily for the education of consumers and providers.
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Provider-specific health care data elements, including severity
adjustment factors, shall be determined by a process which includes
actively practicing providers knowledgeable in data definition, severity
adjustment and regional variation.
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Statistically valid data collection, analysis, and reporting
methodologies, including establishment of a statistically significant
minimum number of cases, shall be developed and appropriately
implemented prior to the release of provider-specific health care data.
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Reliable administrative, technical, and physical safeguards to prevent
the unauthorized use or disclosure of provider-specific health care data
shall be developed. Such safeguards shall treat all underlying
non-public provider-specific health care data and all analyses,
proceedings, records, and minutes from quality review activities on
provider-specific health care data as confidential. Provisions shall be
made that none of these documents be subject to discovery, or admitted
into evidence in any judicial or administrative proceeding.
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The quality and accuracy of the provider-specific health care data shall
be routinely evaluated by a means such as conducting periodic medical
records audits.
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That the WSMA recognizes that the Federal Institutional Review Board
(IRB) process provides an appropriate mechanism to ensure
confidentiality of clinical information and controls its dissemination.
(Res B-5/B-11, A-94) (Reaffirmed A-23)
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Abbreviations for House of Delegates report origination:
EC – Executive Committee; BT – Board of Trustees; CPA – Council on
Professional Affairs; JC – Judicial Council; CHS – Community and Health
Services