Choosing Wisely Guidelines Aren’t Getting Consistent Traction

The first statewide report in the nation to measure Choosing Wisely recommendations finds that patients in Washington may be exposed to care that they don’t need – and potential harm. The report offers county-by-county results in Washington State for nine different Choosing Wisely recommendations.


The first statewide report in the nation to measure Choosing Wisely recommendations finds that patients in Washington may be exposed to care that they don’t need – and potential harm. The report offers county-by-county results in Washington State for nine different Choosing Wisely recommendations.

Choosing Wisely is an initiative of the American Board of Internal Medicine Foundation. The goal of Choosing Wisely is to help providers and patients have conversations about the necessity of tests and procedures and support efforts to help patients make smart and effective care choices. The report was made possible through support from the foundation and the Robert Wood Johnson Foundation.

Report results are based on claims data representing 3.3 million lives in Washington state and were issued by the Washington Health Alliance in conjunction with the Washington State Choosing Wisely Task Force, a group of more than 20 medical leaders from the largest healthcare organizations in the state. The Task Force is co-sponsored by the Alliance, the Washington State Medical Association (WSMA) and the Washington State Hospital Association (WSHA).

Among the key findings of the report:

* Overuse exists. Patients may be getting unnecessary care that costs money and could potentially put them at risk.

* Variation exists. Often the rates between the lowest and highest performing counties vary by more than twofold.

* Where you live and the type of insurance you have (commercial vs. Medicaid) may influence the type of treatment you receive.

To demonstrate that change is possible, the Task Force has launched the Change One Thing initiative, which targets one Choosing Wisely recommendation, “Don’t do imaging for uncomplicated headache,” that participating organizations will focus on implementing in Washington.

“More care is not always better care. The report shows where we’re doing well in Washington state as well as areas for improvement,” said Brian Seppi, M.D., president of the WSMA. “Providing quality, safe care for our patients is paramount. Choosing Wisely provides evidence-based guidelines that provide an opportunity for physicians and patients to have candid conversations about what care is appropriate and needed.”

The report is available here.

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