Authors:
Vera Ries
1
;
Klaus-Peter Thiele
1
;
Bernhard van Treeck
2
;
Sarah Schroeer
1
;
Christina Witt
1
and
Reinhard Schuster
2
Affiliations:
1
Medical Advisory Service Institution in North Rhine (MD Nordrhein), 40212 Duesseldorf, Germany
;
2
Medical Advisory Service Institution in Northern Germany (MD Nord), 23554 Luebeck, Germany
Keyword(s):
Quality Assurance, Statutory Health Insurance, Medical Advisory Service Institution, Communication Structures Between Different IT-Systems, Server Data Structures, Data Protection, Script Programming, Client Office Answers Using Perl Modules, Integer Linear Programming, Consensus, Quality Benchmark, Positive Criticism, Pseudonym-Protected Knowledge Transfer.
Abstract:
16 Regional Medical Advisory Service Institutions perform medical expertise assessments upon German in- and out-patient care. Assessments have to accomplish a nationwide quality assurance plan with mandatory public reporting. We developed strategies to resolve conflicting quality measurement evaluations in the same item by different peers without unveiling the identity of the criticised medical expert or peer in the processes. All workflows are completely digitalized using mathematical IT-based procedures for randomized sampling and for an equal distribution of the medical expertise assessments to be reviewed. We even allow for smaller sample sizes, so regional heterogeneity and the heterogeneity of the types of medical expertise assessment pose a constraint satisfaction problem. We discuss models addressing this kind of problem type and present possible solutions. Our technical framework for peer review distribution, data collection and final result analysis includes a completely IT
-based workflow not only masking the origin of the medical expertise assessments discussed, but routing the peer review processes in a way that independent and impartial review sheets are produced by peers that were previously not yet involved in the reviewing process. Finally, the statistical distribution and outcomes of the review results are analysed.
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