Network Discovers How Well Its Providers Know Choosing Wisely

Fairview Physician Associates (FPA), a network of more than 2,400 specialty and primary care providers based in Minneapolis, Minnesota, recently completed the first year of a two-year strategy to raise awareness about Choosing Wisely® among its clinicians.

FPA is one of several organizations working with the Institute for Clinical Systems Improvement (ICSI), Minnesota Health Action Group and Minnesota Medical Association—three of the 23 organizations awarded grant funding from the ABIM Foundation to advance the Choosing Wisely campaign. The three organizations aligned their strategic efforts under the grant program to broaden their collective outreach, part of which includes awareness-building and educational efforts in practices and hospitals across the state.

FPA defines annual clinical performance objectives (CPOs) that members must meet and that align with network efforts to support the Triple Aim. FPA’s quality oversight committee approved Choosing Wisely as a required 2014–2015 CPO for specialty practices within its network.

The year-one goals for 2014 focused on education. FPA asked practice administrators, providers and staff to:

• Explore the Choosing Wisely website
• Review their specialty recommendations
• Determine what Choosing Wisely materials, including ICSI resources and patient-friendly brochures from Consumer Reports, they would make available within their clinics

FPA surveyed clinics to measure compliance with the 2014 Choosing Wisely CPO. It measured their awareness of the campaign, their specialty recommendations and the resources available to them.

Kourtney Kemp, MD, at Specialists in General Surgery, indicated in the survey that she has done work related to the in-depth review of the Choosing Wisely recommendation on the use of ultrasound instead of computed tomography (CT) to diagnose appendectomies in children.

“Using the information from Choosing Wisely, we determined that our hospitals have been over-utilizing CT scans to diagnose appendicitis in our pediatric patients,” Dr. Kemp said. “By increasing the use of ultrasound technology, we will be more cost-effective and reduce radiation risk to our children.”

Initial feedback shows that FPA member clinics report increased awareness about the Choosing Wisely campaign and the resources available to them to help identify areas to reduce overuse. Dr. Kemp said doctors are using Choosing Wisely materials to engage parents of pediatric patients in conversations about using ultrasounds instead of CT scans. Other feedback has been largely positive, as FPA staff recognized Choosing Wisely recommendations represent long-held standards specialty practices already followed.

This year, FPA will implement the second phase of the strategy and ask practices to:

• Review the Choosing Wisely website and specialty recommendations for updated information
• Continue to make patient education materials available in clinics
• Assess and document opportunities for improvement

Using those goals, Dr. Kemp plans to help connect more patients to Choosing Wisely materials and will continue to focus on implementing the ultrasound recommendation.

“Currently, although our ultimate target is patients, our initial target has been educating our medical primary care physicians so they are on the same page with unified information,” Dr. Kemp said. “We are in the process of applying for a grant to help fund an $8,000 project to help utilize Choosing Wisely in our clinics with electronic screens as well as newsletters to our patients. And, in December, we plan to reevaluate our process at our facility in Maple Grove Hospital to follow up on our progress for ultrasound utilization.”