The Basics

DM 3 echoes URAC's DM 2 requirement that disease experts be involved.  This standard complements the requirement of DM 2 to keep guidelines up-to-date with the help of clinical experts by requiring a similar effort regarding interventions. As is the case with DM 2, DM 3 requires the involvement of clinical experts appropriate to each of the DM programs.

Management Tips

If your program deals with multiple diseases, make sure you have an appropriate clinician for each condition.  Don't assume that one expert fits all.

URAC Accreditation Tips

This standard has a weight of 4.

For the desktop review, you should submit a list showing each clinical expert(s), along with their CVs, for each disease conditions in your program.  In addition, you should submit documentation of your organization's consultation with those experts in reviewing and updating your interventions. Documentation at this phase also should include minutes that indicate their attendance at appropriate meetings.

During the onsite phase, in addition to reviewing the documentation submitted during the desktop review phase, the URAC reviewer will talk to clinical leadership -- including the clinical experts that are the subject of this standard -- to confirm that the experts were indeed involved at the level they need to be involved to fulfill the intent of this standard.