Evaluation of technology transfer by peer review

We report the outcome of an experiment in the field of program evaluation. Because of the rapid outward growth of technology transfer from federally funded laboratories, it was judged necessary to devise a new, yet effective, way of evaluating technology transfer programs and comparing them to conventional research and development projects. Specifically, technology transfer projects within the High-Temperature Superconductivity program of the Department of Energy were subjected to peer review evaluation by a panel of researchers who themselves conduct technology transfer activities. The evaluation criteria and procedures resembled those used for peer review of basic research, but were adapted to the characteristics of technology transfer projects. We include both the viewpoints of a laboratory being evaluated and of the panel chairman. We comment on the degree of success of this evaluation, and draw some conclusions about how it might be modified for the future.     

Federal antitrust jurisdiction in peer review cases: the Pinhas decision

In Summit Health Ltd. v. Pinhas, the United States Supreme Court by a narrow majority found that the exclusion of an ophthalmologist from a hospital in Los Angeles had a sufficient effect on interstate commerce to establish federal jurisdiction under the Sherman Act. In resolving a split among the federal circuit courts of appeal, the Court applied the broad jurisdictional test from McLain v. Real Estate Board of New Orleans, Inc. to peer review proceedings. Despite many ambiguities in the majority opinion by Justice Stevens and a scathing dissent by Justice Scalia, the effect of Pinhas will be to increase the suits in federal court on antitrust grounds brought by aggrieved medical staff members and applicants denied appointments or privileges, and to decrease, if not eliminate, the likelihood of preliminary dismissal on jurisdictional grounds. This, in turn, should serve to emphasize the importance of complying with the Health Care Quality Improvement Act in order to obtain immunity from damages under federal antitrust and state laws.     

The co-regulation of medical discipline: challenging medical peer review

The medical profession has always fiercely defended its right to self-regulation on the basis of peer review. However, in New South Wales, Australia, the profession has willingly surrendered these rights in favour of a disciplinary system known as co-regulation or collaborative regulation, under which disciplinary processes are shared with a "lay" body, the Health Care Complaints Commission. The system constitutes a unique situation in the history of medical regulation. This article examines the origin and operations of co-regulation and comes to the conclusion that its successful operation over the last decade raises questions about whether peer review is indispensable as the basis of medical regulation.     

Protecting Medicare services: trials of a peer review scheme

The Professional Services Review Scheme, established in 1994 under Pt VAA of the Health Insurance Act 1973 (Cth), is a unique attempt to apply peer standards to review of Medicare services. This article examines the evolution of the scheme in the light of extensive litigation.     

Statistical sampling in a legislative framework for peer review of medicare services

This article discusses problems addressed in developing an efficient way of identifying levels of inappropriate professional practice in delivery of Medicare services, using statistical sampling within a legislative peer-review scheme. An efficient alternative to the current sampling methodology is proposed.     

Special report on medical staff relationships. Ninth Circuit buttresses peer review immunities

Following on the heels of Austin, the Fobbs and Smith decisions may result in a significant reduction in the number of federal antitrust claims filed by aggrieved physicians in the context of peer review actions. However, by permitting claims of discrimination and conspiracy to go forward in the Fobbs case, the Ninth Circuit may have encouraged the filing of more suits against peer reviewers based on these types of claims, rather than on antitrust theories. In order to benefit from HCQIA's immunities, medical staffs are once again admonished to review, and revise when necessary their medical staff bylaws and peer review policies to provide for adequate notice and hearing, and to assure that peer review participants are well informed about and carefully comply with all of HCQIA's requirements.