Utilization Review - Providers
Ongoing Professional Practice Evaluation (OPPE)
Ongoing Professional Practice Evaluation (OPPE) Peer Review is used to make final judgements about quality of care in many quality assurance activities. OPPE evaluates practitioners who have been granted privileges and to identify those a practitioner’s clinical and professional competence.
The continuation of clinicians’ privileges at a hospital is based on the quality and safety of care delivered to patients. The review of privileges is a timely, critical, and sensitive process. This responsibility falls on an executive medical committee, which oversees the performance of practitioners with visiting privileges and makes recommendations to hospital as to which medical staff members should receive new or maintain existing privileges.
SFUR has physician specialists noted below that perform these reviews.
OUR CURRENT PHYSICIAN SPECIALTIES
- Bariatric Surgery
- Cardiothoracic Surgery
- Colon Rectal Surgery
- Emergency Medicine
- Family Practice
- General Surgery
- Infectious Disease
- Internal Medicine
- Interventional Cardiology
- Orthopedic Surgery
- Plastic Surgery
- Polysomnography Radiation Oncology
- Radiation Oncology
- Thoracic Surgery
- Vascular Surgery
Typically rural hospitals, smaller regional delivery networks, and large physician specialty organizations will source this function to SFUR.
In rural areas, there are are not enough physicians of the same specialty to provide these reviews. In other settings, physicians feel more comfortable sourcing out this review function to non-biased external physicians rather than their peers that they have to interact with on a daily basis.