Date: March 31, 2026
From: Assistant Under Secretary for Health for Clinical Services
Subj: Information Memorandum: Update on the Implementation of Enterprise-Wide Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE) Specialty-Specific Clinical Indicators (VIEWS 14570839)
To: Veterans Integrated Service Network (VISN) Directors (10N1-23); VISN Chief Medical Officers (10N1-23)
1. The purpose of this memorandum is to provide information on the updated clinical indicators for FY26 related to the Master List for FPPE/OPPE Specialty Clinical Indicators (last published on May 17, 2025). Additionally, it highlights that some clinical indicators have remained unchanged.
2. The FPPE/OPPE National Workgroup (NWG) has approved the following updates to the mandatory specialty clinical indicators. The updated indicators are published on the new Master Clinical Indicator Spreadsheet located here. Updated chart review forms can be found here.
The clinical indicators that have undergone changes include:
a) Anesthesiology, Dermatology, Gastroenterology (GI), Oncology/Hematology, Optometry, Pain Medicine, Physical Medicine & Rehabilitation (PM&R), Podiatry, Pulmonary and Critical Care, Sleep Medicine and Women’s Health.
The clinical indicators with no changes include:
a) Allergy Immunology, Cardiology, Chiropractic Care, Compensation and Pension, Dental, Endocrinology & Diabetes, Mental Health, Nephrology, Pharmacy, Primary Care, Rheumatology, Spinal Cord Injuries and Disorders, and Surgery.
3. Implementation Expectation of Updated Clinical Indicators: The FPPE/OPPE NWG recommends that the updated clinical indicators be approved and implemented at the facility level at the first applicable/new FY 26 FPPE/OPPE review cycle. The recommended steps for implementation based on local bylaws include:
a) Communicate the changes to clinical service leadership and front-line practitioners.
Page 2.
Subj: Information Memorandum: Updates on the Implementation of Enterprise-
Wide Focused Professional Practice Evaluation (FPPE) and Ongoing Professional
Practice Evaluation (OPPE) Specialty-Specific Clinical Indicators (VIEWS
13163710)
b) Executive Committee of the Medical Staff (ECMS) approval of changes.
c) Update the required standard chart review forms as well as any locally used FPPE/OPPE forms with the changes to the clinical indicators and/or clinical evaluation criteria.
d) Inform practitioners requiring FPPE/OPPE of the changes in professional practice evaluations prior to implementation (e.g., virtual training office hours, emails, and recurring meetings).
4. For facilities using Professional Practice Review of Providers System (PPROPS) for OPPE, clinical indicators will need to be updated in the PPROPS system before the next OPPE review cycle.
5. If there are any questions related to the changes pertaining to the approved specialty-specific clinical indicators, please contact the appropriate VHACO ICC and/or specialty-specific lead listed on the Clinical Practice Review Program SharePoint site.
6. Should you have any further questions, regarding post-implementation guidance please contact Dr. Ajay Dhawan, Chief Officer, Specialty Care Program Office at Ajay.Dhawan@va.gov and/or Dr. Praveen Mehta, Chair of OPPE NWG at
Praveen.Mehta@va.gov.
Elizabeth L. Brill, M.D., MBA, FACOG
