Independent Peer Review

Independent peer review provides an external, unbiased approach to evaluating the quality of care delivered by an individual clinician. Peer-matched professionals conduct the evaluations, and their findings are supported by evidenced-based references.

  • Lumetra’s panel includes over 250 physicians, representing almost all specialties and sub-specialties included in the American Board of Medical Specialities, as well as other clinical professionals
  • Population-based measurements dictate the structure of Lumetra’s panel/network
  • Our multi-disciplinary professional team is experienced in handling confidential and sensitive issues associated with health records, in accordance with the Health Insurance Portability and Accountability Act (HIPAA)
  • Our reviewers are experienced in working with electronic health records
  • Lumetra Healthcare Solutions is a URAC accredited Independent Review Organization

Hybrid Peer Review / Customer Specific Review

  • Hybrid panel of university-based clinical reviewers
  • Evidenced-based determinations

Clinical Analytics

Lumetra’s Clinical Services offers reliable data analysis, measurement, and health information services and solutions to help your organization use data to make sustainable improvements. We provide scientific and evidence-based methodology, tools, skills, and insight to help design projects, analyze data, and implement and evaluate programs; promoting integrated healthcare and quality improvement. Lumetra conducts evidence-based literature review, identifies best practices, and establishes benchmarking to track and report data. We provide consultative and direct support to meet the quantitative and qualitative program requirements of our clients.

Data Analysis, Validation and Reporting

Lumetra’s analytic staff comprises expert SAS programmers experienced in the use of advanced statistical techniques to translate data into business intelligence from a variety of sources including claims, inpatient and outpatient data, enrollment, pharmacy, Minimum Data Set, registries and other healthcare databases. Our scientific methods include calculating incidence, prevalence, utilization, outcome and other quality of care measures. We have practices in place to ensure that all sensitive data are kept secure and confidential.

All reports undergo an extensive review process which ensures clarity, accuracy, and confidentiality. Lumetra uses internationally accepted statistical parameters to analyze and validate data.

Our reporting services include:

  • Benchmarking to enable organizations to evaluate and identify their current performance as it relates to best practices of other similar organizations
  • Data analysis and clear, customized feedback reports
  • Comprehensive reports, featuring data tables and charts with concise explanatory text, highlighting the most important findings for non-scientific audiences

Program Monitoring and Improvement

Lumetra is experienced in developing and conducting customer-specific program monitoring and assessment. These assessments can occur on-site or remotely. We can assist you by providing key personnel with experience in monitoring and improving program quality.

Our program monitoring services include:

  • Program and project management
  • Planning and facilitating on-site reviews
  • Developing quality improvement plans
  • Issue identification and resolution