A Little History

In the world of Utilization Management (UM), companies are faced with increasing regulations mandating that UM determinations be made within tight timeframes and cite guidelines and/or peer reviewed reference material. This creates a double-edged sword for UM, as requirements demand more comprehensive reports in less time.

EBM+ ^SM  began as a research project. The primary goal was to identify ways to quickly locate relevant, unbiased literature for physician reviewers involved in making utilization management determinations. The underlying project theory was that turnaround times could be improved when three criteria are satisfied:

     1) Relevant UM literature could be pre-screened and compiled in a database for faster retrieval,
     2) Appropriate reference materials could be sent with case records to the reviewing physician, and
     3) Literature could be integrated with medical coding systems and keywords to improve reference specificity.

Liberation Technology, Inc. funded the project and worked in cooperation with Physicians’ Review Network, Inc. (PRN). Both of these companies are located in Phoenix, Arizona and are physician-owned corporations employing diverse workforces.

PRN was an appropriate partner, as its caseload includes a majority of appeal level reviews and workers compensation cases, all of which require supporting reference citations. PRN’s database yielded a core foundation of UM relevant   literature cited in more than 14,000 recent review determinations. From this point, the EBM+ ^SM  database continued to expand to include additional reference material based on input from beta test users and thousands of physician reviewers.

The database continuously expands to accept new reference material submitted by healthcare professionals thus enabling EBM+ ^SM  to incorporate current material as new technology emerges. Participating Physicians continually provide comment and feedback on the database contents. Database content is also subject to review by an editorial board of physicians and by physician specialty editors. Thus, EBM+ ^SM  is a dynamic physician maintained database.

Today, EBM+ ^SM  offers a unique service that marks a new era in Utilization Management.