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Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Prospective drug utilization review refers to assessing appropriate drug and decision making therapeutically before patients' medication are dispensed. [10] This prospective review is based on the history recording of the drug and medication. Then, practitioners could assess therapy for patients on the basis history recording. [11]
Verification is intended to check that a product, service, or system meets a set of design specifications. [6] [7] In the development phase, verification procedures involve performing special tests to model or simulate a portion, or the entirety, of a product, service, or system, then performing a review or analysis of the modeling results.
Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. [ 1 ] [ 2 ] A discipline-specific process may be referenced accordingly (e.g., physician peer review , nursing peer review ).
Extended peer review is the process of including people and groups with experience beyond that of working academics in the processes of assuring the quality of research. If conducted systematically, this can lead to more reliable, or applicable, results than a peer review process conducted purely by academics. [125]
It is used to gather vendor information from multiple companies to generate a pool of prospects. This eases the RFP review process by preemptively short-listing candidates which meet the desired qualifications. A request for solution (RFS) is similar to a RFP, but more open and general. This allows the vendor or supplier the most flexibility of ...
A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. [1] A systematic review extracts and interprets data from published studies on the topic (in the scientific literature), then analyzes, describes, critically appraises and summarizes interpretations into a refined evidence-based ...
The prospective study is important for research on the etiology of diseases and disorders. The distinguishing feature of a prospective cohort study is that at the time the investigators begin enrolling subjects and collecting baseline exposure information, none of the subjects have developed any of the outcomes of interest. [2]