From Utilization Review to Outcomes Measurement: A Medical Sign of the Times?

By Janice Simmons . In 1989, an Institute of Medicine committee report stated that "with great speed and relatively little public awareness, a significant change has occurred in the way some decisions are made about a patient's medical care." Known as utilization review, that change is still very much in evidence. . Physicians still complain about the more objectionable aspects of utilization review, notably additional paperwork and inconvenience. But for the most part, it has become "part of the landscape," notes Robert A. Berenson, M.D., medical director of the National Capital Preferred Provider Organization in Springfield, Va. . Yet, its impact appears to be lessening as more attention is being focused on the end result of medical care - clinical outcomes. . Changes Afoot . During the last several years, the medical community has seen a difference in the methodology and philosophy toward cost and value issues, says Andrew Webber, executive vice president of the American Medical Peer Review Association, Washington, D.C. "A whole new movement lets us look at quality of care through the application of scientifically based measures of performance." . In the past, the medical industry's focus was to look at those issues "in the context of individual cases and to use the judgment of individual clinicians" to determine whether "care ...

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