As one of the nation’s premier healthcare quality evaluation organizations since 1984, IPRO is active in 34 U.S. states and territories. Our wide-ranging portfolio of activities includes working with providers on clinical quality improvement projects; providing independent external oversight of Medicaid fee-for-service and managed care service delivery; supporting the provision of high-quality End-Stage Renal Disease services to 127,000 dialysis and transplant patients residing in 13 U.S. states and acting as an impartial clinical review agent for patients and families lodging appeals of service denials in 18 states and the District of Columbia.
Recent landmark activities have included support for the nation’s first public performance report to analyze hospital-specific management of sepsis involving adults and children, including development of risk-adjusted mortality data. The New York State report is the culmination of a three-year effort at data collection, measurement and analysis, under the auspices of a statewide clinical advisory group, aimed at improving sepsis detection and outcomes at acute care hospitals across the state of New York.
Another critically important activity has been development of New York’s first comprehensive online provider look-up tool. Consumers who want to learn which providers participate in which health plans now have an online resource to quickly help them with their research. The NYS Provider and Health Plan Look-Up is now available to all insured individuals in New York.
Over the past several years, we have been building a comprehensive internal quality management program that incorporates key elements of ISO (the International Organization for Standardization) as well as Lean. ISO is an international quality management system that focuses on meeting quality and regulatory requirements, enhancing customer satisfaction and continually improving business performance. IPRO has held ISO certification since 2003; we recently achieved certification to the newly-developed ISO 9001:2015 Standard, which emphasizes the need for risk-based thinking.
Simultaneous to our success in upgrading our ISO certification, IPRO has integrated Lean methodologies into our organization-wide Quality Management System, with a specific focus on key performance indicators. We believe that the organization-wide adoption and realization of these combined methodologies clearly demonstrates that, for IPRO, quality improvement is as much of an internal commitment as it is an external business focus.