Regional Collaboratives to Play Key Role in Reducing Unnecessary Medical and Clinical Treatments

PORTLAND, ME – Five members of the Network for Regional Healthcare Improvement were chosen by the ABIM Foundation to lead a national effort in reducing duplicative health care testing and reducing unnecessary antibiotic use. The aim of the project, Choosing Wisely, is to engage physicians and patients to ensure the most appropriate care and improve clinical outcomes.

The Choosing Wisely Program, supported by the Robert Wood Johnson Foundation (RWJF), will bring together health care organizations from across the country that have already established strong collaborative partnerships within their regions, to focus on the implementation of at least three Choosing Wisely recommendations. These recommendations, or areas of focus, include reducing the use of antibiotics for viral infections by at least 20 percent over nearly three years at participating health systems, hospitals, and medical groups in their regions. Each site awarded a grant will receive $315,000 to fund these activities. This is the second waves of funding provided through the Choosing Wisely program. As it did for the first round of Choosing Wisely grants, NRHI will provide technical assistance to the grantees.

“The selection of Regional Health Improvement Collaboratives, or RHICS, to do this critical work is reflective of their deep commitment to regional healthcare improvement through collaboration and multi-stakeholder engagement,” says Elizabeth Mitchell, President and CEO of the Network for Regional Healthcare Improvement. “RHICs are uniquely positioned to bring all the key stakeholders together at the local level, provide objective data, and develop meaningful, actionable plans for qualitative and quantitative health care improvement. RHICs have been recognized as effective leaders in this work and look forward to partnering with organizations in their communities to improve the delivery of health care.”

“This campaign is a partnership between clinicians, community groups, and the people of Maine communities. We’re eager to have an opportunity to partner with both health care providers and community groups and learn from them about how to shift thinking about what health care we really need and what we don’t need,” said Dr. Lisa Letourneau, Maine Quality Counts Executive Director.

The NRHI-member RHICs selected to lead this work are:

  • Greater Detroit Area Health Council –The Greater Detroit Area Health Council will work with the Michigan State Medical Society, the Detroit Medical Center Physician Organization, The Henry Ford Physician Network and other partners to reduce unnecessary care in the Detroit region. The Council will focus on reducing the use of antibiotics for viral infections among adults, diagnostic testing for low back pain, and screening for Vitamin D deficiencies.
  • Integrated Healthcare Association – California’s Integrated Healthcare Association will partner with provider organizations Sharp Rees-Stealy Medical Group (San Diego County) and Sutter Health (Sacramento/Central Valley/San Francisco Bay), the California chapter of the American College of Physicians, the Center for Healthcare Decisions, and Blue Shield of California. Their project will aim to reduce the utilization of antibiotics for adult bronchitis, diagnostic testing for low back pain, pre-operative stress testing, imaging for uncomplicated headache and repetitive complete blood count (CBC) and chemistry testing.
  • Maine Quality Counts – Maine Quality Counts (MQC) will work with local partners and statewide organizations such as the Maine Medical Association, the Maine Osteopathic Association, Consumers for Affordable Healthcare, Maine Area Agencies on Aging, Mid Coast Health System, Martin’s Point Health Care, Penobscot Community Health Care and St. Joseph Healthcare system. A previous ABIM Foundation Choosing Wisely grantee, MQC’s project will focus on reducing the use of antibiotics for adult bronchitis, diagnostic testing for low back pain, and prescriptions for benzodiazepines for adults 60 and over.
  • Washington Health Alliance – The Washington Health Alliance, a previous ABIM Foundation Choosing Wisely grantee, will continue to partner with the Washington State Medical Association, another Foundation grantee, and provider organizations including the Group Health Cooperative and Swedish Health Services. They will target the overuse of antibiotics for upper respiratory viral infections, imaging for uncomplicated headaches and overly frequent Pap tests for women between the ages of 30 and 65.
  • Wisconsin Collaborative for Healthcare Quality – The Wisconsin Collaborative for Healthcare Quality (WCHQ) will lead an effort to reduce the utilization of antibiotics for viral infections in adults, imaging for low back pain, imaging for headaches and inpatient blood utilization. A past ABIM Foundation partner in advancing Choosing Wisely, WCHQ will partner in this effort with provider organizations Froedtert & the Medical College of Wisconsin and Monroe Clinic, and the Wisconsin Academy of Family Physicians and the Wisconsin Medical Society.

The above listed RHICs will work collaboratively with the following organizations (not NRHI regional collaborative members) toward achieving the Choosing Wisely goals:

  • North Carolina Healthcare Quality Alliance – The North Carolina Healthcare Quality Alliance is partnering with the North Carolina Medical Society, Duke Medicine, Cornerstone Health Care, Blue Cross Blue Shield of North Carolina and the State Health Plan for Teachers and State Employees. They will focus on reducing the use of antibiotics to treat viral infections in adults, DEXA scans to measure bone density in women younger than 65 and men younger than 70, carotid artery stenosis screening in asymptomatic patients, and annual Pap tests for women between the ages of 30 and 65.
  • UCLA Department of Medicine – The UCLA Department of Medicine will lead a coalition of six partners including the Los Angeles County Department of Health Services (LAC DHS), the LA County Department of Public Health, the LAC DHS Primary Care Practice Based Research Network, The Wellness Center at Historic General Hospital, and the Society of General Internal Medicine. The partners will focus on reducing imaging for nonspecific low back pain, pre-operative testing, and antibiotics for viral-based upper respiratory illness.

This Choosing Wisely announcement marks the second selection of grantees to advance the Choosing Wisely campaign. From 2013 – 2015, 21 projects led by state medical societies, specialty societies and regional health collaboratives helped educate physicians about the recommendations and build skills to have conversations with patients about the care they need. Highlights of their work can be found in a new report entitled “Advancing the Choosing Wisely Campaign in Clinical Practices and Communities.

The Network for Regional Healthcare Improvement is a national organization representing over thirty five member Regional Health Improvement Collaboratives. These multi-stakeholder organizations are working in their regions and collaborating across regions to transform the health care delivery system and achieve the Triple Aim: improving the patient experience of care, including quality and satisfaction; improving the health of populations; and reducing the per-capita cost of health care. The RHICs are accomplishing this transformation by working directly with physicians and other health care providers, provider organizations, commercial and government payers, employers, consumers, and other health care-related organizations. Both NRHI and its members are non-profit, non-governmental organizations.

About the ABIM Foundation: The mission of the ABIM Foundation is to advance medical professionalism to improve the health care system. The ABIM Foundation achieves this by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policy makers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice.

About the Robert Wood Johnson Foundation: For more than 40 years, the Robert Wood Johnson Foundation has worked to improve health and health care. RWJF is striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come.