For reviews that do not involve the medical care or health plan circumstances of a particular patient, MCMC’s Medical Care Ombudsman Program offers a variety of non-case review services.

Our expert analyses and evaluations cover:

• Practice Guidelines – Our analysis of guidelines for coverage, practice or technology decision-making include medical review criteria, clinical or critical pathways, and disease management protocols.

• Technology Consultations – Upon request, our panel of reviewers and other experts assess new and emerging medical technologies or the status of established technologies for clients who need quick answers to questions about the use of medical technology for a defined group of patients.

• Research Studies – We conduct expert reviews of clinical trials or other research studies to determine the scientific adequacy of the study, the clarity and scientific importance of the research question, the extent to which the proposed methods would provide unequivocal answers to the research questions, and the protection of human subjects of the research.

A leader in medical technology assessments, MCMC developed a tool for health plans to consider the implications of groundbreaking prospective clinical trials on the effectiveness of high-dose chemotherapy with bone marrow transplants for breast cancer patients. Today, our analyses of experimental or investigational treatments involve high-dose chemotherapy, solid organ transplantation, and other high-tech diagnostic or therapeutic procedures.

Our high quality, independent non-case reviews help our clients make informed health care choices, decrease care delivery costs, reduce exposure to litigation, and improve patient safety and outcomes.

Non-Case Review Questions Often Addressed:

• Is there sufficient information (in the accompanying medical records) to answer the following questions?

• Is the central research question to be addressed by the clinical trial clear?

• Is the central research scientifically important? That is, can an unequivocal answer to this question be expected to influence patient care by reinforcing existing practices, suggesting practitioners adopt a different practice, or suggesting the further development of this or another treatment?

• Are the research methods, including sampling, randomization, data collection and analysis, scientifically adequate? That is, can they reasonably be expected to produce an unequivocal answer to the central research question?

• Is patient informed consent adequate in terms of specifying expected benefits and risks and meeting other generally-accepted standards?

• Does the patient meet the criteria for enrollment in the trial?

• Is the patient’s participation in the trial appropriate, considering the patient’s condition and availability of health-beneficial alternative therapies, etc.?

For more information on MCOP's extensive services, please call 888-313-6267, 301-652-1818 or e-mail mcman@mcman.com.