ABIM Foundation's Choosing Wisely®

Promoting the ABIM Foundation Choosing Wisely® Campaign

Avoiding wasteful or unnecessary medical tests, treatments and procedures is critical to creating value in the U.S. health care system. Under a grant from the ABIM Foundation’s Choosing Wisely® campaign, IHA is partnering with Sharp Rees-Stealy Medical Group in San Diego County; Sutter Health in the Sacramento/Central Valley/San Francisco Bay areas; the California chapter of the American College of Physicians; the Center for Healthcare Decisions; and Blue Shield of California to reduce overuse of antibiotics for adult bronchitis, diagnostic testing for low back pain, pre-operative stress testing, imaging for uncomplicated headache and repetitive complete blood count (CBC) and chemistry testing. Project partners are also participating in a related effort, Smart Care California.

 

Conference Session: Tackling Overuse of Imaging – Improving Patient Outcomes, Reducing Costs

IHA’s annual Stakeholders meeting in September 2016 featured a session on strategies to tackle the overuse of imaging, a priority area for the Choosing Wisely® initiative. Overuse of imaging can lead to unnecessary care, including surgery, and increase costs without improving patient outcomes.  In 2015, an IHA-led team of partners launched a project to reduce overuse through Choosing Wisely, which includes recommendations on reducing unnecessary imaging for low back pain and uncomplicated headache. Two partners on the grant –Sutter Health and Sharp Rees-Stealy-- are adopting an array of interventions to reduce inappropriate imaging. Sutter Health is providing comparative performance feedback on imaging for uncomplicated headache to clinicians at targeted sites, and is tracking and reporting on site-level change over time. Sharp Rees-Stealy has focused on patient engagement:  in partnership with Consumer Reports, Sharp Rees-Stealy has created a “microsite” that provides patients with access to Consumer Reports materials on imaging for low back pain (among other topics) and has made patient-facing materials available for clinicians to use.  In addition, Cedars-Sinai Health System was the first system in the nation to incorporate Choosing Wisely recommendations into its EMR.  Two years ago, Cedars implemented a clinical decision support tool that alerts physicians who order a test or treatment that is referenced on the Choosing Wisely lists – including those for imaging – and has been tracking results.  Speakers from all three systems shared experiences to date in efforts to reduce inappropriate imaging toward better care and lower costs. 

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Webinar: The Role of the Citizen Voice in Reducing Overuse (May 2016)

This webinar explored public views gathered through the Doing What Works project about what steps, if any, should be taken to limit unnecessary care. Led by the Center for Healthcare Decisions (CHCD), Doing What Works used public deliberation--a distinctive process for identifying priorities when trade-offs may be needed in policies pertaining to treatment and coverage decisions. Rather than ask the public what patients want, Doing What Works asked the public what policy-makers should do to resolve the problem of overuse. The project focused on three examples: antibiotics for adult bronchitis, C-sections for first-time low-risk pregnancies and MRIs for common low back pain. 

Webinar presenters:

  • Jill Yegian, Ph.D., Senior VP, Programs and Policy, IHA (Moderator)
  • Beccah Rothschild, M.P.A., Senior Outreach Leader, Health Impact Team, Consumer Reports
  • Marge Ginsburg, M.P.H., Executive Director, Center for Healthcare Decisions
  • Julia Logan, M.D., M.P.H., Quality Officer, California Department of Health Care Services
  • Lance Lang, M.D., Chief Medical Officer, Covered California

Watch the webinar recording.

Download the webinar slides.

Read the Doing What Workexecutive summary or the full report.
 

Press Release

Integrated Healthcare Association Selected as Choosing Wisely Grantee in Campaign to Reduce Use of Unnecessary Tests and Treatments
 

Project Information

Overview: Decreasing Inappropriate Care in California in Partnership with Choosing Wisely

Summary of Measures, Data and Targets
 

Resources

In December 2015, David Wolfson of the American Board of Internal Medicine Foundation (ABIMF) interviewed Jill Yegian, IHA’s project lead. The video interview, which covers the project's 3-year objectives and strategies, is posted on the Choosing Wisely website.

The American College of Physicians, California Chapter (ACP) Annual Scientific Meeting held in November 2015 featured a presentation by Dr. Darin Latimore, the Immediate Past President of the Chapter and member of IHA’s Statewide Workgroup on Reducing Overuse project. Dr. Latimore provided an overview of the Choosing Wisely initiative and ACP’s primary role in engaging physicians to participate.

IHA’s annual Stakeholders meeting in September 2015 featured a session on the IHA-led Choosing Wisely initiative. Over 90 attendees heard from Jill Yegian and our project partners, Ann Marie Giusto from Sutter Health and Dr. Parag Agnihotri from Sharp Rees-Stealy, about their interventions underway for year one. In addition, Beccah Rothschild from Consumer Reports spoke on consumer engagement efforts in support of the Choosing Wisely campaign.

Choosing Wisely in the News

The Center for Healthcare Decisions (CHCD) was featured in the California Health Care Foundation’s (CHCF) blog discussing the initiative Doing What Works. The purpose of the project is to identify the perspectives of insured Californians on ways to reduce the use of medical services that are harmful and or wasteful.

Sharp Rees-Stealy Medical Group was featured in an article in the Union Tribune that discusses the new partnership with Choosing Wisely ® and the medical group’s commitment to reducing overuse.