As health systems across the country shift their attention and efforts to improving quality care while reducing its overall cost, it is important that clinicians are able to walk patients through the potential benefits and costs—both physical and financial—of certain tests, procedures, treatments or screenings. Having an open, honest conversation about the care provided to patients isn’t always easy. While a patient may believe they need a certain test or medical procedure, their physician may view it as unnecessary or be concerned that the procedure itself could pose a potential risk.
In 2012, the American Board of Internal Medicine (ABIM) launched its “Choosing Wisely” campaign to educate providers on which tests, treatments, or procedures they should call into question if they pose potential for unnecessary cost and little health benefit—referred to as “low-value” care. The campaign sparked a national dialogue among clinicians about how to reduce excessive care. Recently, a group of researchers from the Dartmouth Institute for Health Policy and Clinical Practice published the results of a 2014 survey on Atrius Health physicians’ views on health service overuse and their awareness of Choosing Wisely. At the time of the study, 41 percent of our physicians had awareness of Choosing Wisely, compared to a benchmark of about 21 percent national awareness in an ABIM survey.
At Atrius Health, we have been working within our organization to address excessive and low-value care for several years. Our process has entailed the following steps:
- Conducting provider education seminars at all of our sites on common services which are overused and represent low-value care
- Created and disseminated internal guidelines on several topics to help clinicians with these conversations
- Tracked and shared data on low-value services with providers 2-4 times per year
These initiatives help us increase patient and provider awareness of appropriate use of services—including those which are typically underutilized—to improve our patients’ overall health.
Though we feel we have been well ahead of the curve on this issue, it is clear that health systems still have much work to do on a national level.
At Atrius Health, strong patient relationships, understanding and trust are the foundation upon which we deliver high-quality and cost-effective care. As we continue having these important conversations with our patients, we look forward to working with other health systems and organizations to expand this dialogue and deliver the most valuable care possible to those we all serve.
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