Case Study: Access and Overuse in Rural Settings

Kansas Healthcare Collaborative (KHC) is a nonprofit 501(c)3 organization dedicated to transforming health care through patient-centered initiatives that improve quality, safety, and value. KHC was formed in 2008 by the Kansas Hospital Association and the Kansas Medical Society to act as a resource and continually enhance care provided to Kansans, and to become a trusted source for relevant and meaningful health care quality improvement education, evaluation, and measurement.
Problem
Health care outcomes in rural communities are often worse than those in suburban and urban areas, while levels of overuse are typically similar. Longer delays in receiving appointments, longer travel times to see clinicians, and extended waits in medical offices add to the cost of unnecessary tests and treatments.
Solution
Leaders from KHC educated clinicians about overuse, introducing Choosing Wisely to more than two dozen practices and health systems by providing staff and patients with materials that focused on “5 QUESTIONS to Ask Your Doctor.” At some sites, clinicians also began asking open-ended questions to increase conversations with patients and printed Choosing Wisely materials on checkout papers.
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