Winning Ideas and Innovations: Teaching and Creating Value in Health Care to Reduce Waste and Improve Outcomes

PHILADELPHIA – Today the ABIM Foundation, Costs of Care, and the Leapfrog Group announce winners of the Creating Value Challenge, a competition aimed at recognizing innovative ideas and projects for teaching and implementing high-value health care among collaborative teams of clinicians, educators, quality improvement specialists, and health system administrators.

From the 83 submissions received, a panel of nationally recognized judges selected four winners:

Creating Value winners focused on implementing high-value care in clinical practice:

• Linking Quality and Costs – Team-based, Physician-led Care Redesign for Top 50 Medical Conditions using Value-Driven Outcomes
  • University of Utah Health Care initiated an enterprise-wide effort to improve clinical outcomes and reduce costs by building a tool to manage, analyze, and report data, called Value-Driven Outcomes. This tool allows clinicians and managers to analyze actual system costs and outcomes at many levels, including by individual encounters, department, physician, diagnosis, and procedure. Physicians are provided information about quality and costs of care to help them identify value improvement opportunities, areas where their care delivery may vary significantly from their peers, and ways they could redesign care.

• Prevention prescription
  • Rami Farraj, MD, Chairman of the Royal Health Awareness Society and an internist at the King Hussein Medical Center in Jordan shared a simple yet effective project that advocates for primary care physicians to write a “prescription” for their patients to attend interactive awareness sessions before their next appointment. During these sessions patients learn new skills to empower them to live healthy lifestyles and avoid chronic diseases.

Teaching Value winners focused on improving medical education curricula around delivering high-value care:

• Radiology-TEACHES: (Technology Enhanced Appropriateness Criteria Home for Education Simulation)
  • Over 20% of imaging studies in the US have been estimated to be unnecessary, creating cost, quality, and safety consequences for patients[1]. However, it is difficult to address this issue once clinicians are in practice within the existing health care system. Recognizing that medical education curricula often lack evidence-based guidance regarding appropriateness and cost of imaging examinations, radiologists at Baylor College of Medicine partnered with the American College of Radiology and the National Decision Support Company to create Radiology-TEACHES (Technology Enhanced Appropriateness Criteria Home for Education Simulation). This online portal simulates the process of ordering imaging studies with integrated clinical decision support. Learners receive this evidence-based feedback at the virtual point of order entry, thereby better understanding appropriate imaging utilization and empowering them to reduce waste.

• Engaging students in Educational and Practice Transformation: High-Value and Person Centered Care Taught Through Virtual Families
  • Eastern Virginia Medical School implemented a new curriculum, called CareForward, using a virtual community of culturally-diverse families to bring reality-based clinical scenarios to life. Through their stories, students learn the primary determinants of health outcomes, including socioeconomic factors, health literacy, social support, and other non-clinical determinants of health. They also learn how to deliver patient- and family-centered, cost-conscious, high-value care informed by the unique needs of the elderly, those with multiple chronic conditions, and a host of social determinants of health such as access to healthy food and safe neighborhoods. By learning about health and disease in the context of (virtual) people’s lives, students engage in improving health outcomes rather than blaming patients.

Honorable mention:

• Use of Simulation to Assess Incoming Interns’ Recognition of Opportunities to Choose Wisely
  • While many graduate medical education programs incorporate simulations and safety training, the University of Chicago Pritzker School of Medicine modified its “Room of Horrors” simulation to also train interns about avoiding low-value care. The simulation addressed four areas of health care overuse articulated by Choosing Wisely® specialty society recommendations, including arbitrary blood transfusions despite stable hemoglobin and unnecessary use of restraints. This first-of-its-kind simulation involves 125 interns, representing 60 medical schools and 13 specialties.

“For the third year in a row we challenged American health care workers to create and teach new ways of providing better care at lower cost,” said Neel Shah, MD, Founder and Executive Director of Costs of Care. “This year’s submissions represent the depth of the challenges we face, as well as the scope of what is possible when the ingenuity and dedication of those on the frontlines of healthcare delivery are brought to the fore.”

Leah Binder, CEO of The Leapfrog Group, offered a special congratulations to health systems that contributed five or more submissions to the Challenge. “Just as we recognize health systems that excel, we also were gratified to see organizations that appear to be on a tireless journey of improvement, with one project after another leading them to even greater achievements in quality and efficiency,” Ms. Binder said.

The institutions in alphabetical order were:

• Crozer Chester Medical Center (Pennsylvania)
• Greenville Health System (South Carolina)
• Johns Hopkins (Maryland)
• Michigan Medicine (formerly University of Michigan Health System, Michigan)
• University of Chicago (Illinois)
• University of Utah (Utah)
• VA Ann Arbor Healthcare System (Michigan)

“Congratulations to the Creating Value Challenge winners, and thank you to all who entered for aspiring to making health care better and inspiring us with your ideas,” said Richard J. Baron, MD, President and CEO of the ABIM Foundation. “It is incumbent upon us as clinicians to provide the best possible care to our patients, and sometimes that means we stop doing the things we know won’t help them get better. The winning projects are outstanding examples of how we can improve the way we teach and practice medicine so that doing the right thing becomes the easy thing.”

A panel of national health care leaders served as judges for this year’s Creating Value Challenge:

• Ceci Connolly, CEO, Alliance of Community Health Plans
• Sachin Jain, MD, CEO, Caremore Health System
• Michael Millenson, President, Health Quality Advisors
• Rita Redberg, MD, Editor-in-Chief, JAMA Internal Medicine
• Clay Johnston, MD, PhD, Dean, Dell Medical School, University of Texas–Austin

The Creating Value Challenge builds on the ABIM Foundation’s Choosing Wisely® campaign, a national effort in partnership with Consumer Reports that encourages clinicians and patients to have conversations about avoiding unnecessary tests and treatments. Health care professionals from any discipline and level of training were invited to participate in the Creating Value Challenge and submit short abstracts that described either a project they had already implemented or an idea for a project they believe could have promise in delivering better care at a lower cost. Winners will be recognized and present their projects at the Association of American Medical Colleges Integrating Quality (AAMC IQ) meeting June 8–9, 2017 near Chicago.

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About the ABIM Foundation 

The mission of the ABIM Foundation is to advance medical professionalism to improve the health care system. We achieve this by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policy makers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org, connect with us on Facebook or follow us on Twitter.

About Costs of Care 

Costs of Care is a nonprofit organization that curates insights from the frontlines of health care to help delivery systems provide better care at lower cost. Connect at www.CostsOfCare.org or follow us on Twitter @CostsofCare.

About The Leapfrog Group

Founded in 2000 by large employers and other purchasers, The Leapfrog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American health care. The flagship Leapfrog Hospital Survey collects and transparently reports hospital performance, empowering purchasers to find the highest-value care and giving consumers the lifesaving information they need to make informed decisions. The Leapfrog Hospital Safety Grade, Leapfrog’s other main initiative, assigns letter grades to hospitals based on their record of patient safety, helping consumers protect themselves and their families from errors, injuries, accidents, and infections.

[1]  Rao VM, Levin DC. The Overuse of Diagnostic Imaging and the Choosing Wisely Initiative. Ann Intern Med. 2012;157:574-576. doi: 10.7326/0003-4819-157-8-201210160-00535

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