Date: June 3, 2017

To: May January, Manager

From: Anna Bufalo, Project Coordinator
RE: A proposal to purchase XYZ Peer Review Database, a software package for the management
of Clinical Peer Review

Purpose:

I propose we invest in XYZ Peer Review Database to fully automate our current Clinical Peer
review process. The automation will allow ABC Medical Center to improve the quality of care
for patients and assist in meeting the Regulatory agencies, as well as state and federal
legislation, that mandate peer review activities to access physician and other provider
performance.

Current Problem:

Our Clinical Peer Reviews are mailed out the reviewers and returned to us via mail or fax. The
reviews are maintained manually by the Peer Review Department, 4 full-time non-clinical and 1
clinical staff members. Each staff member manages an average of 6 reviews per day. The
reviews are handwritten and can be difficult to read. The data is stored in a homegrown access
that was created in 2007 by an Datawarehouse Management Systems, a company which went
out of business in 2015.

Our current policy requires the reviews be completed and evaluated every 8 months, in a 2-
year cycle and have a clinical staff of 500 providers. Based on the number of providers, we are
required to maintain at a minimum of 1500 reviews in a 2-year cycle. As projected by Risk
Management, in 2016, the number of providers is expected to grow by 50% in the last 5 years.

The Peer Review Department is having have a difficult time keeping up with the reviews. As
previously stated, the database was created in 2007 and reporting from the database is limited.
There is sometimes a 6-month lag before the inappropriate or controversial reviews are
presented to Review Committee. The database is old and requires extensive maintenance.
Since the closing of Datawarehouse Management Systems, our Information Services
department has worked on the database 10 times since the beginning of the year. The charge
back to Information Services is now overbudget.

Proposed Solution:

Many Healthcare organizations are looking for methods to standardize their processes and
create meaningful measurements. XYZ Peer Review Database offers an amazing product that
would improve quality of patient care, meet JCAHO standards and decrease productivity time.
The database will provide us with simplified data storage and tracking, along with automated
reports and letters.
Benefits of XYZ Peer Review Database:
User Friendly Secure Environment for Reviewers to complete on-line evaluations.
Designated reviewers to create and complete peer reviews in a timely manner.
Uniformly track both adverse outcomes as well as document best practices.
Supports state and federal compliance activities by providing a standardized process
from initiation to conclusion.
Owned by Siemens Corporation.

Cost of XYZ Peer Review Database:

XYZ Company cost is minimal in comparison to the fees associated with noncompliance from
the regulating bodies or patient quality issues directly relate to clinical staff. In 2016, the Legal
department reported ABC Medical Center patient quality issues amounted over 4 million
dollars.

XYZ database license is based on per provider fee, yearly server and maintenance fees, which
include program enhancements due regulation changes.

Number of Providers Per Provider Cost Yearly Maintenance Fee

100 or less $100 $20,000
500 101 $75 $18,000
500 or greater $50 $15,000

ABC Medical Center Peer Review Department requested and denied additional staffing last
November. The recommended database will free up the current from day to day data entry
and allow for critical evaluation of the reviews. Additionally, this will give us the opportunity to
restructure our department, as we had proposed to the Budget Department in 2016 with the
additional cost of FTEs.

The overall estimated implementation cost of the project is $75,000. This includes the vendor
licensing and ABC Medical Center Information Services time.

The expected time of completion from purchase date is 120 days.

Conclusion

I feel this change is a necessity. ABC Medical Center is losing millions of dollars related to
patient safety issues due to clinical staff. The Peer reviews are implemented by the regulatory
bodies to stop the issues before they happen. XYZ Peer Review Database will allow us to
improve our departments productivity that will ultimately improve the quality of care for
patients and assist in meeting the Regulatory agencies.