Peer review facilitates sharing of outcomes info
Peer review facilitates sharing of outcomes info
Many pharmacists lack peer review privilege
Pharmacists involved in disease state management (DSM) activities may find that they have to meet regulations specific to DSM.
Regulators are looking at DSM activities through structure, process, and outcomes, says Edward D. Rickert, RPh, JD, partner with Smith, Rickert & Smith in Downers Grove, IL. Rickert spoke about disease state management in his presentation, "Practicing Pharmacy in the 21st Century: Liability and Practices Concerns," at the American Pharmaceutical Association’s 2002 Annual Meeting and Exposition in Philadelphia in March. "Structure is the characteristics of setting, such as personnel, computers, and equipment. Process is how available resources are used, such as counseling, drug utilization review, compliance, and the accuracy rate. Outcomes are whether the patient’s health is improving or at least being maintained."
If outcomes are evaluated and health professionals try to determine what went wrong in a bad outcome, then the sharing of information is imperative. "You are going to want a free flow of information and frank discussion about what happened in connection with a patient’s care," Rickert says.
Peer review can help in this situation. A peer review privilege protects information discussed during proceedings in which quality-of-care issues are analyzed and a health care professional’s competence may be discussed, he explains. It also protects participants from litigation brought by a heath care professional who feels he has been injured by the peer review committee.
Peer review statutes aimed at physicians may be deemed broad enough to include participation by pharmacists, Rickert says. "But it can also be argued that the privilege is waived if a pharmacist sits on the committee."
Some people think peer review issues are really just a way of protecting the person who made the mistake or protecting the institution, the hospital, or the pharmacy from liability. "That’s kind of a cynical view," Rickert says. "The reason that you have these peer review statutes is because you want to foster full disclosure, a full exchange of information, without any fear of it coming back to hurt you."
Very few states, however, recognize peer review privileges for pharmacists. Texas and California did recently pass laws that provided peer review protections for pharmacists more directly. "I think it’s time that we start looking at pharmacists as members of the health care team and give them the same type of peer review protections that other members have," Rickert says.
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