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:
- The methods for collecting and analyzing provider-specific health care data shall be disclosed to providers under review and to the public.
- 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.
- Provider-specific health care data shall be valid, accurate, objective, and used primarily for the education of consumers and providers.
- 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.
- 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.
- 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.
- 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.
- 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-17)
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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