PubMed · 7566017
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T R Fulda. 1995-11-09. Computer-based drug-utilization review.. https://doi.org/10.1056/nejm199511093331916
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The views of producers, purchasers, and users of provider profiling concerning this practice were studied. A snowball sample of individuals representing seven groups with a stake in retrospective provider profiling were interviewed by telephone over a 12-week period in 1997. Participants were asked what they believed were the most important uses for profiles, who should receive copies of profiles, and what the limitations of profiles are. A semi-structured format was used to ensure that each interview was comparable and complete. The responses were aggregated, and qualitative research approaches were used to analyze them. A total of 40 people were interviewed. A majority of the respondents cited physician education, changing physician behavior, and monitoring and improving the quality of care as valid uses of provider profiles. A majority believed that the recipients of profile data should include the individual providers being profiled, medical administrative staff, people directly involved in the profiling program, pharmacists, and health plan administrators. The respondents acknowledged many limitations of profiles, with the top concern being inherent problems in the use of billing and administrative databases for profiling. Interviews with stakeholders in provider profiling yielded insights into the strengths and weaknesses of profiling, as well as echoing findings reported elsewhere. Health system administrators and health care professionals need to be aware of these issues as they use and modify profiling.
To strengthen guidelines for vancomycin use, practical guidelines were developed. A prospective survey was conducted of all patients receiving vancomycin during two 1-month periods, 1 year apart, during which significant improvements were noted. Practical guidelines may contribute to appropriateness of vancomycin use, serve as educational tools, and facilitate improved surveillance.
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