QUALITY IMPROVEMENT (QI) REVIEW SYSTEM AND METHOD

摘要

A computer-implemented clinical quality review method involving: for each of a plurality of medical problem types, storing a corresponding set of review criteria; receiving a plurality of electronic patient care records (ePCRs) from a medical service provider (MSP), each ePCR identifying a patient treated by the MSP and information about the medical care provided to that patient by the MSP, including: clinical problem type, clinical impressions, symptoms, and details about the evaluation of and treatment provided to that patient by the MSP; and for each ePCR: (i) determining whether the medical care meets the set of review criteria associated with the medical problem type identified in that ePCR; (ii) if the medical care passes the set of review criteria, approving the medical care provided to that patient and forwarding information about the medical care provided to that patient to a reporting system; and (iii) if the medical care does not pass the set of review criteria, generating a notification indicating that a manual review of the medical care provided to that patient is required.