In support of its ongoing participation in the ABIM Foundation’s Choosing Wisely® campaign, the American Urological Association (AUA) recently recognized the team of Drs. Mitchell Humphreys, Peter Black and Ithaar Derweesh as Choosing Wisely Champions.
As part of their participation in the AUA Leadership Program, Drs. Humphreys, Black and Derweesh surveyed AUA members to determine their awareness of and adherence to the society’s first set of Choosing Wisely , which were released in 2013. Their findings showed that 43 percent of responders said they knew about the recommendations, with nearly 76 percent of that group saying they found them helpful to their practice. Forty-five percent of respondents cited lack of publicity as the most common barrier to wider adoption.
“People were aware of the recommendations and they referred to them. But if you also gave them a tool, they would use them more and the result would raise the bar for quality of care patients receive regardless of location, age of provider and so on,” said Dr. Humphreys. “The goal is to standardize the simple things.”
Dr. Humphreys and his colleagues developed an electronic medical record (EMR) tool that provides point-of-care education to physicians when they attempt to order something that goes against Choosing Wisely guidelines. The alert prompts physicians to consider their rationale for a particular test or treatment, and allows them to proceed, amend the order or obtain more information.
“This is one of those things that can translate to better patient care for everyone. No matter where someone goes, you know they’re going to get the same quality of care for their patients,” he said.
Dr. Humphreys and his colleagues are looking for ways to encourage adherence to AUA’s Choosing Wisely recommendations in practice, including working with EMR vendors to incorporate the tool in their platform and exploring ways urologists can earn Maintenance of Certification (MOC) credit for using Choosing Wisely in quality improvement efforts.
“These recommendations are very clear-cut and designed to benefit patients. If you have an EMR that can track ordering patterns and send out a report, that really simplifies things for everyone,” he said. “It also helps identify outliers who may be over-ordering. Then you can work on an educational plan to help that clinician.”
Dr. Humphreys is a consultant and professor in the Department of Urology at the Mayo Clinic in Arizona, serves as the associate dean of the Mayo School of Continuous Professional Development and is the Endourology Fellowship director. Dr. Black is a urologic oncologist at Vancouver General Hospital, as well as a research scientist at the Vancouver Prostate Centre and an associate professor in the Department of Urologic Sciences at the University of British Columbia. Dr. Derweesh is a professor of surgery in the Division of Urology at the University of California, San Diego, where he also serves as program director of the Urologic Oncology Fellowship.
In 2016 AUA selected a total of four Champions, including the team of Drs. Humphreys, Black and Derweesh—as well as Dr. Danil Makarov—for their commitment to the Choosing Wisely program, advancing the campaign at the Association level (as well as in their local practices) and demonstrating leadership in these efforts.