The Basics of Ongoing Professional Practice Evaluation
What Is Ongoing Professional Practice Evaluation?
In healthcare, ongoing professional practice evaluation (OPPE) is a process that reviews and assesses a provider’s performance over a period of time. OPPE can be used to determine whether a provider maintains their privileges at a healthcare facility or remain on staff, as well as monitor performance and identify trends or issues that could adversely impact patient outcomes.
OPPE requirements are determined by The Joint Commission (TJC), which recommends healthcare organizations use a well-designed process that supports early detection and response to performance issues that could negatively impact patient outcomes. A well-designed OPPE process incorporates both qualitative and quantitative data.
- Quantitative data can easily be measured in terms of percentages, ratios, and other numerical forms. OPPE data may include information such as infection or complication rates, compliance with regulations and hospital rules, and length-of-stay trends.
- Qualitative data is collected through observations, discussions with others, and physician monitoring. This could include descriptions of patient outcomes, quality of documentation, types of procedures performed, and peer recommendations.
TJC originally coined the term OPPE, but other accreditation organizations may require a similar reporting process to assess physicians’ abilities to maintain their privileges and continue to practice in a particular facility.
What Is the Difference Between OPPE and FPPE?
In addition to OPPE, The Joint Commission also requires healthcare organizations to complete focused professional practice evaluation (FPPE). While OPPE reviews a physician’s performance over a period of many months, FPPE is a snapshot of a provider’s performance at a moment in time.
FPPE is required to grant privileges to new applicants or to authorize new requests for existing providers. The process can also be used for further evaluation if OPPE reveals a potential issue around a provider’s ability to provide safe, quality patient care.
How Often are Physicians Evaluated?
Organizations that are accredited by TJC must meet FPPE and OPPE requirements to grant privileges to providers. According to The Joint Commission’s OPPE standards, the reappointment/re-privileging process must be completed every two years.
TJC specifies that the healthcare organization can define the frequency of OPPE data collection, but the timeframe for the review cannot exceed every 12 months. However, many organizations find this to be too infrequent and prefer to perform OPPE reviews every four to six months.
How Axiom Clinical Analytics Supports Ongoing Professional Practice Evaluation Reporting
Syntellis’ Axiom™ Clinical Analytics features ongoing professional practice evaluation (OPPE) reporting to help hospitals and health systems support a continuous reporting cycle for privileging, credentialing, peer review, and clinical improvement.
Answers to the Top 8 OPPE Questions
1. How does physician privileging work?
OPPE Reporting allows your organization to perform systematic measurement, evaluation, and follow-through to support compliance and maintain hospital accreditation. Axiom Clinical Analytics supports effective ongoing professional practice evaluation (OPPE) to identify physicians who might not be achieving quality-of-care standards and focused professional practice evaluation (FPPE) to monitor physicians identified by OPPE.
2. How does Clinical Analytics support OPPE credentialing requirements?
You can vet physician competence and practice history through performance reporting to meet OPPE credentialing requirements and support physician recredentialing as needed. Complete credentialing to comply with state regulations and payer requirements.
3. How can peer reviews improve quality?
By aggregating data for agreed-upon OPPE metrics in the current period and over time, you can use peer reviews to analyze technical and service quality, patient safety, and resource utilization. Data can be reported to your medical executive committee, which interprets the data and makes recommendations to the Board of Trustees.
4. How can OPPE improve clinical outcomes?
OPPE Reporting provides a continuous feedback loop for key process and outcome measures, adjusted for severity and risk. Reporting cascades through the system, hospital, service line, department, clinical unit, physician, and patient levels, graphically displaying calls to action.
5. Does OPPE include both inpatient and outpatient reporting?
Of course! Axiom’s OPPE Reporting supports reporting needs with two primary areas of functionality: comprehensive inpatient and outpatient reporting and physician attribution reporting. Click here to review a sample report.
Axiom’s reporting capabilities enable organizations to enhance and streamline their physician reporting process. Users can create reports based on inpatient and outpatient data for individual physicians and physician groups using a balanced set of measures — patient safety, quality, patient satisfaction, utilization, and cost — in addition to other OPPE metrics, such as patient complaints and delinquent histories and physicals (H&Ps).
Axiom Clinical Analytics Inpatient and Outpatient Reporting can include 17 analytics, such as physician volumes, procedure counts, and outcome visualizations. Axiom Clinical Analytics users can also electronically create, distribute, and review custom physician reports within the application, modifying report profiles, use of benchmarks, selected measures, and more.
6. How efficient is OPPE Reporting?
Users can create reports on a preselected schedule using automated scheduling functionality, electronically routing reports through a hierarchy of reviewers — based on parameters such as time period, physician or physician group, and physician role — where each reviewer can complete standardized reviews, annotations, and sign-offs. User-specific permissions allow for security across the application.
7. Can physicians access their reports?
With Axiom Clinical Analytics, physicians can explore their own OPPE reports and drill down into their cases through dynamic physician scorecards and interactive dashboards. Physician scorecards and dashboards provide data based on the user’s role. Administrators can manage and track all reporting, including in-progress workflows and completed workflows, and report reviewers can see their own user-specific pending and completed reviews.
8. Can physician contribution be measured?
Axiom Clinical Analytics’ powerful physician attribution algorithm works to identify an attributed physician who made the largest contribution to each encounter’s outcomes of care. The attributed physician for each encounter is defined through a rule-based hierarchy that looks at data elements including cost, orders, ordering physician, diagnostic and procedural coding, and diagnosis-related group (DRG). Click here to learn more.
System logic helps prioritize certain charges, such as operating room charges and charges based on the DRG.
Axiom software describes how the attributed physician was selected, with user-override capabilities, and further identifies physicians with the highest charges and highest number of orders by encounter.
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