Choosing Wisely® Resources

Resources

Choosing Wisely Lists and Resources

More than 70 medical societies have joined the Choosing Wisely campaign and collectively identified more than 450 tests and treatments that may be unnecessary. Each specialty society list provides information on when tests and procedures may be appropriate based on the evidence, as well as the methodology used in its creation. These recommendations are intended to encourage clinician and patient conversations about reducing care that provides limited benefit or may even cause harm so appropriate treatment plan based on evidence-based guidelines can be made.

Presentations

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. 

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 initiativeOver 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.

Videos and Webinars

Consumer Reports has developed videos about the Choosing Wisely campaign and specific tests that may be unnecessary. Video topics include imaging for low back pain, antibiotic use, and chest x-rays before surgery. 

In May 2016, The Role of the Citizen Voice in Reducing Overuse 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.

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.