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:

1. The methods for collecting and analyzing provider-specific health care data shall be disclosed to providers under review and to the public.
2. 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.
3. Provider-specific health care data shall be valid, accurate, objective, and used primarily for the education of consumers and providers.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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