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Peer Review eNews

We Do More Than Peer Review.

5/23/2023

 
​​Our Peer Reviewers can provide remote mentoring to enhance decision making skills.
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​Onsite or virtual proctoring is accomplished through direct observation to evaluate a practitioner’s competency to carry out actual clinical care and takes both cognitive and procedural abilities into account. Onsite or virtual proctoring is accomplished through direct observation to evaluate a practitioner’s competency to carry out actual clinical care and takes both cognitive and procedural abilities into account.    ​
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​Mentoring and proctoring results should only be used during your internal quality control and peer review processes and/or for improving care. These services are not deemed as the provision of medical services. 
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​Virtual or onsite fair hearing support to answer questions related to the clinical review of cases, to discuss findings, and provide rationale for the review determination.  The fair hearing process follows the hospital’s By-Laws and is peer-review protected by the Health Care Quality Improvement Act (HCQIA) of 1986.  
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​​Other Consultative Services include, but not limited to: new technology/procedure reviews, medical imaging/radiology overreads, patterns of care, complex or highly specialized reviews, ambulatory/outpatient records, review of internal peer review or quality documents, and provider education.  
​In partnership with you, we will work to define the scope of work and pricing.  

CIMRO Welcomes Two New Board Members

3/31/2023

 
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Phillip M. Rowell II, MJ is an information technology executive with a passion for healthcare currently serving as a Chief Analytics Officer with Health Catalyst’s Technology Enabled Managed Services Division and Vice President of Health Outcomes for Carle. 

He is an innovative, outcomes-focused and patient centered senior leader with nearly twenty years of experience in health information technology, population health management, and analytic design. 

Prior to joining Carle, Mr. Rowell was the Director of Technology Consulting with PricewaterhouseCoopers Australia and he also held positions at Cerner Corporation and Avanade, Inc.  He obtained his Bachelor of Business Administration, Economics and Master of Jurisprudence, Health Law degrees from Loyola University. Mr. Rowell is a member of AMA, AMGA, and Pacific Health Information Network and co-founder of Willow Grove International, LLC.    
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​​Yashail Vora, MD, MSc, FRCSC is board certified in neurological surgery and since 2008 has served as attending neurosurgeon with Kaiser Permanente in Oregon and southwest Washington.

Dr. Vora completed medical school, obtained a Master of Science degree, and completed his neurosurgery residency at the University of Alberta where he received many honors and awards during medical school.  Additionally, he completed a neurosurgical oncology fellowship at MD Anderson Cancer Center. 

​Prior to joining Kaiser Permanente, Dr. Vora served as the attending neurosurgeon at the VA Medical Center of Nebraska and Iowa and Assistant Professor of Neurosurgery at Creighton University School of Medicine.  Dr. Vora has been a CIMRO physician reviewer since 2004 and for Healthcare Quality Strategies, Inc. since 2012. He has authored numerous publications and scientific presentations, and has been invited faculty at several institutions. Dr. Vora is a member of the Royal College of Physicians and Surgeons.   

National Doctor's Day - We Appreciate and Thank You!

3/30/2023

 
Healthcare today is more complex than ever. With more advancements, tools, and information at their fingertips, doctors have an overwhelming job to diagnose and treat their patients every day. This is the day to honor the ones who see us 365 days a year. In every city and hospital, in our military, and in our rural communities, doctors pave the way to better healthcare for their patients. 

​On March 30th each year, National Doctors Day honors the professionals for their dedication and contributions to society and the community. Their dedication puts the patient first time and again. On National Doctors Day, we say “thank you” to our physicians for all that they do for us and our loved ones.

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February: An Opportunity to Show Appreciation and Gratitude

2/13/2023

 
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February is a month to celebrate our most treasured relationships. For us, that’s you – our clients and partners! 

Thank you for the kindness shown through our recent Client Engagement Survey. Your overall experience and satisfaction with our services averaged 4.8 on a 5-point scale. Additionally, 82.4% of respondents Strongly Agree, and 17.6% Agree, that the CIMRO team is readily available and communicates timely, effectively, and with professional courtesy. That’s 100% of the time! 

We loved what some of our clients had to say:
  • “Your service is excellent.  Response time is phenomenal.  Staff are always very professional.”
  • “The reviewers' qualifications and experience are highly regarded.”
  • “CIMRO reviews are very thorough and timely.”
  • “We receive excellent customer service each time we request a review.  The process is user friendly as well.  The reviewers provide comprehensive feedback and resources for our physicians.”
  • “Everyone that we work with at CIMRO is amazing!!  Very prompt in responding and so friendly and helpful.  We appreciate the work that is done for us and look forward to a continued working partnership.”

If we can assist with your peer review needs – contact us at peerreview@cimro.com or through our website at www.cimro.com.    

External Peer Performance Evaluations: Did You Know?

1/23/2023

 
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Did You Know?.... that nearly 30% of CIMRO’s reviews are External Peer Performance Evaluations (EPPEs)? EPPEs are an affordable external review option.
 


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Suitable for:
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  • Ongoing ROUTINE assessments and performance analysis for a single practitioner or multiple practitioners of a department.

NOT suitable for:

  • Records over 100 pages.
  • Custom questions for the peer reviewer.
  • Comments, narrative, or detailed responses from the peer reviewer.
  • A known or strong suspicion of a quality concern.
  • Neurosurgery and mortality reviews.

What you can expect:

  • Use of a standard review questionnaire and succinct responses from the peer reviewer – answers will be yes, no, or n/a only.
  • An overall rating will be provided for each record reviewed.
  • An aggregate report of variances allowing for identification of practice patterns or areas of concern.
  • If additional detail is desired upon receipt of the EPPE report, clients may request a teleconference with the peer reviewer billed at the hourly rate or request an additional review priced according to the Agreement for Review Services.

A New CEO and CIMRO Turns 50

1/10/2023

 
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While I may be the new CEO for CIMRO, I am certainly not new to CIMRO. I was at CIMRO from 1996 - 2006 as Director of Operations. When I started at CIMRO, I was 22 years old and had just completed by BSN. At the time, I was still living at home with my parents.

Over the past 15 years, I have gained considerable experience and am incredibly grateful for the opportunities provided through the various leadership positions held at Carle Health and Health Alliance, most recently as SVP/Chief Clinical Integration Officer.


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From the Medical Director's Desk | Audra Thomas, MD

1/9/2023

 
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​You might ask yourself, What is the job of the medical director at CIMRO? Simply put, I review the peer reviewers. I review all the independent review organization (IRO) insurance reviews, a random sampling of peer review reports,  and  any reports that have generated questions or complaints. There are rules and accreditation standards that govern our reviews. What do I look for when conducting a review?   


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Meet the CIMRO Team

1/9/2023

 
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​Learn a little more about several members of the CIMRO team: Jennifer Clark, RN, MSN; Marge Donoghue, RN, BS; Dustin Kerchner; Cindy Scopel, RN; and Rita Tayler, RN, BSN, MS.



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Liability Coverage - Am I Protected?

1/9/2023

 
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A frequent question related to liability protection arises in conjunction with peer review activities.  The Health Care Quality Improvement Act of 1986 (HCQIA) provides good-faith immunity from state and federal liability for people participating in the peer review process.  


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External Peer Performance Evaluations (EPPE) Reminders/Expectations

1/9/2023

 
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The External Peer Performance Evaluation (EPPE) is an affordable external peer-review option suitable for ongoing ROUTINE assessments and focused performance analysis. It is designed to evaluate the performance of a single practitioner or multiple practitioners in a department.

The client provides a small, focused record for review – fewer than 100 pages.  As such, these reviews are not expected to take as long as comprehensive independent peer reviews (less than 60 minutes in most instances). EPPE is not appropriate for neurosurgery or mortality reviews, or if there is a known or strong suspicion of a quality concern.


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  • Home
  • Peer Review Services
    • Why Outsource?
    • Review Types
    • Peer Review Process
    • Peer Review Panel
    • Pricing
    • Department of Insurance
  • Why Choose CIMRO?
    • Our Physicians
    • Secure e-Messaging
    • Quality
    • Customer Service
    • Testimonials
    • Experience
    • Value
    • Integrity
  • About Us
    • Careers
    • Leadership
  • Contact Us
  • News
  • Reviewer Portal
  • 🔍 Search