21 Organizations to Engage Physicians and Patients in Conversations on Overuse of Medical Tests and Procedures

PHILADELPHIA—The ABIM Foundation has awarded funding to 21 state medical societies, specialty societies and regional health collaboratives to help physicians and patients engage in conversations aimed at reducing unnecessary tests and procedures. Support for the grant program comes from the Robert Wood Johnson Foundation (RWJF).

The grants extend the reach of the ABIM Foundation’s Choosing Wisely® campaign in communities across the United States. Launched in April 2012, Choosing Wisely is focused on encouraging physicians and patients to think and talk about medical tests and procedures that may be unnecessary, and in some instances can cause harm. Since April 2012, 25 medical specialty societies have created lists of tests and procedures they say are overused or inappropriate, and that physicians and patients should discuss.

Choosing Wisely grantees will work on projects to help educate practicing physicians about the recommendations from the specialty societies and help build physician communication skills to have conversations with patients about the care they need. Grantees will also participate in a learning network that will allow them to learn from one another and enhance the effectiveness of their programs.

“Physicians say they sometimes have difficulty saying no to requests from patients, even when they know a particular test or treatment is unnecessary,” said Christine K. Cassel, MD, President and CEO of the ABIM Foundation. “Through the work of these grantees we’ll be able to help physicians in local communities across the country be better prepared to engage in conversations with their patients about the care they truly need.”

Examples of grantee projects include:

• The Texas Medical Association (TMA) will promote and disseminate Choosing Wiselyrecommendations to more than 47,000 physicians and medical students by collaborating with Texas county medical societies, the Texas Osteopathic Medical Association, and state medical specialty societies. TMA will inform and engage patient advocacy groups, employers, and community leaders in the Choosing Wisely campaign in Texas and will create a learning collaborative of practices that have agreed to implement the Choosing Wisely recommendations to identify best approaches for broader replication.
• The American Society of Echocardiography will build a mobile application that physicians can use to quickly search for and access the society’s Choosing Wisely recommendations and other appropriate use criteria to determine whether a cardiovascular ultrasound exam is appropriate for a patient.
• Better Health Greater Cleveland will disseminate the recommendations and messages of theChoosing Wisely campaign through in-person educational sessions led by respected clinicians, and state-of-the-art digital education for clinicians and consumers. The effort will target practicing physicians and their nursing colleagues, while leveraging relationships with Northeast Ohio’s medical schools and residency programs to reach medical students and residents.
• The American Society of Nuclear Cardiology (ASNC) and Massachusetts Medical Society will develop a web-based application to collect data on physician ordering patterns for cardiac imaging tests, with the data being used to define the rate of appropriate and inappropriate referrals, as well as interventions for meaningful improvement. ASNC will also develop a patient-friendly web site for physicians and their patients to inform patients about nuclear cardiac imaging and radiation optimization.
• Maine Quality Counts will conduct public and physician awareness campaigns utilizing traditional and social media to educate patients and physicians about Choosing Wisely and will provide resources to support informed decision-making about appropriate use of health care resources. They will also work with three local provider organizations that will serve as mini Choosing Wiselypilot sites. These sites will select key Choosing Wisely recommendations and a set of specific measures to implement, with a goal of identifying best practices and barriers to change that could be shared more broadly.

“There is a growing conversation in America about how we can improve health care quality and reduce overuse,” said John R. Lumpkin, MD, Senior Vice President and Director of the Health Care Group at the Robert Wood Johnson Foundation. “Physicians play a leading role in these conversations, and we look forward to seeing how these projects will help advance the Choosing Wisely campaign.”

The grants will run from April 1, 2013 to March 31, 2015. State medical societies and specialty societies will receive $50,000, and regional collaboratives will receive $70,000. The grants are made possible thanks to generous support from the Robert Wood Johnson Foundation. RWJF also provided support for the ABIM Foundation to share best practices through a Choosing Wiselylearning network and additional funding for Consumer Reports’ efforts to educate consumers about the Choosing Wisely lists.

Organizations awarded grants include:

Regional Collaboratives
Better Health Greater Cleveland
HealthInsight Utah
Institute for Clinical Systems Improvement and Minnesota Health Action Group
Iowa Healthcare Collaborative
Maine Quality Counts
Massachusetts Health Quality Partners
Michigan Health Information Alliance
Puget Sound Health Alliance
Wisconsin Collaborative for Healthcare Quality

Societies/State Medical Associations
American Academy of Hospice and Palliative Medicine
American Academy of Ophthalmology
American College of Physicians
American Society for Clinical Pathology
American Society of Echocardiography
American Society of Nuclear Cardiology and Massachusetts Medical Society
Minnesota Medical Association
Oregon Medical Association
Society of Hospital Medicine
Tennessee Medical Association
Texas Medical Association
Washington State Medical Association

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