Purchasers of health care – employers, consumers and public agencies – for decades have experienced record growth in spending. Yet evidence does not support that there has been a corresponding improvement in quality and a return on these investments. The Congressional Budget Office estimates that up to 30 percent of care delivered in the United States goes toward unnecessary tests, procedures, doctor visits, hospital stays and other services that may not improve people’s health – and, in fact, may actually cause harm.
It is urgent that physicians and patients work together to make wise treatment decisions – that means helping patients choose care that is supported by evidence that it works on patients like them, it is not duplicative (meaning that it isn’t a test or procedure that they already received from another doctor), it won’t harm them, and that it is truly necessary. It is equally important that more evidence-based guidelines are developed to ensure that health care providers can practice evidence-based medicine.
Highlighted below are several efforts underway to address treatment decisions between patients and doctors, as well as developing evidence-based guidelines and making research based information accessible to patients and the public.
Choosing Wisely is an initiative of the ABIM Foundation (American Board of Internal Medicine) designed to help physicians, patients and other health care stakeholders think and talk about overuse of health care resources in the United States. Initially, nine specialty societies, representing 375,000 physicians, each identified five tests and procedures that might warrant additional conversations between doctors and patients about the need – or lack thereof – for these frequently ordered tests or treatments. More than 70 societies representing over one million clinicians are now partners of the Choosing Wisely campaign. Over 220 test and procedures have been identified as “not always necessary.”
Institute for Clinical Systems Improvement
Also known as ICSI, their mission is to “…champion the cause of health care quality and to accelerate improvement in the value of the health care we deliver to the populations we serve. ICSI’s vision is to be a collaboration that is deemed essential by its members for their improvement of health care and deemed essential by our community as a trusted voice for quality in health care.”
ICSI is a non-profit organization formed in 1993 in direct response to the Minnesota Health Action Group’s stipulation that providers participating in The Action Group’s new preferred provider organization developed in 1992 have continuous quality improvement programs in place. Founding organizations were HealthPartners, Mayo Clinic and Park Nicollet Health Services. Today, ICSI is a membership organization comprised of 55 medical groups representing about 85 percent of Minnesota physicians. Its demonstrated collaborative and innovative processes enable ICSI to unite diverse stakeholders in the health care system to deliver patient-centered and value-driven care. For more information on the work done by ICSI, click here.
Patient Centered Outcomes Research Institute
Authorized by Congress as part of the Accountable Care Act, the mission of the Patient Centered Outcomes Research Institute, more commonly referred to by the acronym PCORI, is to conduct research to provide information about the best available evidence to help patients and their health care providers make more informed decisions. PCORI’s research is intended to give patients a better understanding of the prevention, treatment and care options available, and the science that supports those options.
PCORI funds research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health care decisions. For more information about PCORI, click here.