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Healthcare Transformation Learning Session June 25th Webinar, 1:00 - 2:00 PM Learning Topic: Choosing Wisely - physicians, patients and other health care stakeholders to think and talk about medical tests and procedures that may be unnecessary, and in some instances can cause harm. Sharing Lessons Learned • Krista Stock, Director, Healthcare Collaborative of Greater Columbus • Sarah Durfee, RN, Clinical Programs Officer, Ohio Public Employees Retirement System • Greg Sawchyn, MD, MBA, Senior Director - Clinical Guidance Councils, OhioHealth Lead Support

Major Support

Additional Support 100% of our Board of Directors & Staff Individual & Corporate Donations

www.hcgc.org


Why?

The Healthcare Collaborative of Greater Columbus is coordinating regional activities to spread awareness and adoption of Choosing Wisely速.

The initiative aims to help physicians, patients, and other healthcare stakeholders think and talk about appropriate use of healthcare resources. Physician-led effort to advance evidence-based medicine and help patients make smart and effective care choices.

www.hcgc.org


Components of the National Initiative Messengers and Collaborators  60 specialty societies representing 500,000+ physicians; 250+ overused tests and procedures

Communicate Messages  Specialty societies, Consumer Reports, employer and consumer organizations, ABIM Foundation, regional healthcare organizations Activate  Concrete action around unnecessary tests and procedures


5QUESTIONStoAsk Your Doctor Before You Get AnyTest, Treatment, or Procedure 1 Do I really need this test or procedure? Medical tests help you and your doctor or other health care provider decide how to treat a problem. And medical procedures help to actually treat it.

2 What are the risks? Will there be side ef ects? What are the chances of getting results that aren’t accurate? Could that lead to more testing or another procedure?

3 Are there simpler, safer options? Sometimes all you need to do is make lifestyle changes, such as eating healthier foods or exercising more.

4 What happens if I don’t do anything? Ask if your condition might get worse — or better — if you don’t have the test or procedure right away.

5 How much does it cost? Ask if there are less-expensive tests,

treatments or procedures, what your insurance may cover, and about generic drugs instead of brand-name drugs.

Use the 5questionstotalk toyour doctor about whichtests, treatments, andproceduresyouneed— andwhichyoudon’t need. Some medical tests, treatments, and procedures provide little benef t. And in some cases, they may even cause harm. Talk to your doctor to make sure you end up with the right amount of care — not too much and not too little. 3

FOR M ORE INFORM ATION

Use your sm ar tphone to access all of the lists of tests and procedures for you and your physicians to question as part of the Choosing Wisely ® cam paign.

http://consumerhealthchoices.org/campaigns/choosing-w isely/

Tools and resources can be found at: www.consumerhealthchoices.org


Applying Learning from National Choosing Wisely Conference (May 2014) Key learning from others (WHAT)

Applying learning in Greater Columbus (HOW)

A. Focus efforts on measuring the • Assist people with using the right questions via use of at least one question to Patient Engagement Education and Training – help people receive reaching people through our purchaser and provider high-quality healthcare at a partners lower cost • Assist patient-centered medical homes with using five Choosing Wisely questions in their exam rooms B. Align Choosing Wisely with • Providers – align with quality improvement current activities in your region initiatives

• Purchasers – align with health/wellness initiatives C. Emphasize Shared Responsibility to improve healthcare with consumers, providers, and purchasers www.hcgc.org

• Shift our framing from improving “value-based healthcare literacy” to improving “shared responsibility”


Learning from Providers

Physicians recognize their responsibility to be good stewards of our health care dollars • Frequency of unnecessary tests and procedures is a very or somewhat serious problem (73%) • Physicians have a great deal of responsibility to make sure patients avoid unnecessary care (66%) • On average, a physician prescribes an unnecessary test or procedure 1x per week (72%)

Source: The ABIM Foundation’s National Survey of Physicians, By Perry Undem Resarch/Communication, May 2014

www.hcgc.org


Learning from Providers

Support Physician-Patient conversations • Patients ask for an unnecessary test or procedure at least once a week (47%) • Even if they know a medical test is unnecessary, physicians order it if the patient insists (53%) • After speak with a patient about why a test or procedure is unnecessary, the patient often avoids it (70%)

Source: The ABIM Foundation’s National Survey of Physicians, By Perry Undem Resarch/Communication, May 2014

www.hcgc.org


Learning from Providers

Changing “habits” has both opportunities and challenges • Providers will have to “unlearn” routines that have been instilled in them since medical training. • Organizations will need to take a hard look at process that contribute to unnecessary care. • Explore ways to automatically provide clinical decision support tools

www.hcgc.org


Learning from Providers

Emerging non-physician role in contributing to the body of evidence-based recommendations Coming Fall 2014: • American Academy of Nursing • American Dental Association • American Physical Therapy Association

www.hcgc.org


A number of no-cost resources are available for our partners in Greater Columbus that wish to incorporate Choosing Wisely® into their own communication campaigns. • Communications tools such as campaign messages, talking points, digital communication tips, and social media resources. • Clinical Decision Support incorporating evidence-based guidelines into clinical pathways

www.hcgc.org

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Participating Central Ohio Primary Care Franklin County Medical Mutual of Ohio Ohio Public Employees Retirement System The Ohio State University Health Plan School Employees Retirement System of Ohio Emerging Participants Berger Health System Columbus Public Health InHealth Mutual Medical Group of Ohio Mt. Carmel Health System National Church Residences Nationwide Insurance OhioHealth Syntero


Regional Activity

Aligning Choosing Wisely with local initiatives: Featured purchaser Ohio Public Employees Retirement System Sarah Durfee, RN, Clinical Programs Officer

www.hcgc.org


Regional Activity

Aligning Choosing Wisely with local initiatives: Featured provider OhioHealth Greg Sawchyn, MD, MBA, Senior Director - Clinical Guidance Councils

www.hcgc.org


Choosing Wisely at OhioHealth June 25, 2014

Greg Sawchyn, MD, MBA Sr. Director – Clinical Guidance Councils


Clinical Guidance Councils

HCGC support - Educating physician leaders from around the system Reinforcing what we are already doing –

Eliminating <39 week elective inductions – CT utilization in ED for headaches – Transfusion thresholds – Back pain imaging

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Source of new opportunities Use of consumer materials and resources


Aligning Value

Setting up CW micro site for our Health4 Network in conjunction with the Medical Group of Ohio –

Aligning ongoing value transformation and measures with Choosing Wisely recommendations –

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Consumer focus

Provider focus


Next Steps

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Integration with Epic EMR Aligning data analysis efforts with recommendations Diving deeper into the recommendations Implementing consumer education strategy


Healthcare Transformation Learning Session

What assistance is available to advance Choosing Wisely in Greater Columbus? A number of no-cost resources are available for our partners in Greater Columbus that wish to incorporate Choosing Wisely into their own communication campaigns.

 Customized, co-branded microsites offering tools for consumers that will be maintained and regularly updated by Consumer Reports Health.  Co-branded poster for use in wellness communications. This poster offers five questions that patients should ask their doctor about any medical test or procedure.  Communication tools such as campaign messages, talking points, digital communication tips, and social media resources.

If your organization is interested in exploring any of these resources, please contact John Leite (john@hcgc.org)

www.hcgc.org


Healthcare Transformation Learning Session

Text your questions via webinar option or to 614-906-2440

www.hcgc.org


THANK YOU! • Thank you for joining us today!

Please save the dates for scheduled learning sessions

• Thanks to our speakers! • Thanks to our funding partners! • Please respond to the evaluation question via poll

Lead Support

Major Support

• Webinar: 7/23, 1-2PM Open Notes • In-person: 8/22 & 12/5 8:30-11:30AM

Additional Support 100% of our Board of Directors & Staff Individual & Corporate Donations

www.hcgc.org


June 25th Healthcare Transformation Learning Session Slides