The cornerstone of conducting medical audits is to prevent medico-legal issues. At Hinduja, medical audits take into consideration peer review, death review, which is a very important preventive step and pre-step to medical audit, mortality, morbidity, analysis of diagnoses, operative procedures, inventory investment, bed occupancy and utilisation, says Dr Iyer. To see if customer needs are satisfied, support services like waiting and attending period are also taken into account. Medical scene today is completely unregulated. And one of the reasons for non-ponderance, says the expert, over audits is that doctors are not systematically trained in medical audits as their curriculum only talks about patient management, whereas various audit parameters at hospital level is omitted.
Medical audit encompasses two parts - clinical and administrative.
While the medical community in India can reasonably handle the clinical part of medical audits, which is a part of hospital management system, it is administrative audits where we are incompetent, says Dr Gyani. Providers must realise that medical audit aims not to find faults of doctors but unearth the bottlenecks in diagnostic, therapeutic and support services area. According to Dr Iyer, audit process should be regular, sustainable and repeatable. And just as shareholders have an access to balance sheet of corporates, audits conducted in hospitals must be made available to those who wish to view it, she feels. The semi-legal nature of the regulation by health insuring companies will also keep a certain amount of check on the statistical outcomes of the treatment process.