Choosing Wisely Work Group
Revised 2/5/14
Purpose and Core Objectives: Equip physicians and patients to engage in conversations
aimed at reducing unnecessary tests and procedures to improve the quality of care through
improved choices about healthcare utilization.
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Physician Engagement- (participation, skill acquisition, demonstrate leadership)
Improve the Value of Care- (Quality/Cost, alignment of improvement initiatives)
Sustainability- (long-term change the culture and delivery of care)
Members
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Tom Evans, MD, Iowa Healthcare Collaborative
Ryan Meyer, Iowa Healthcare Collaborative
Clare Kelly, Iowa Medical Society
Ed Whitver, Iowa Medical Society
Tim Gutshall, MD, Wellmark Blue Cross and Blue Shield
Jason Kessler, MD, Iowa Medicaid Enterprise
Don Skinner, MD, McFarland Clinic PC
John Yost, MD, UnityPoint Health
Michael Miller, MD, University of Iowa Hospitals and Clinics
Jeff Maire, DO, Mercy Health Network
Strategy
1) Develop an Iowa specific subset of CW practices to promote across the Iowa provider
community (the “Iowa Five”).
a. Selection Criteria (Cost, Compelling message, Alignment with current work,
Measurable, “physician” focused)
b. Selection Process
i. Used IMS Survey of physicians to highlight top 5 areas
Based off of the survey results, the Iowa 5 as the most important recommendations to
physicians are:
1. Don’t obtain imaging studies in patients with non-specific low back pain; and don’t do
imaging for low back pain within the first six weeks, unless red flags are present. *Due
to very similar language, these two recommendations were combined into one.
2. Don’t do imaging for uncomplicated headache. Imaging headache pains absent specific
risk factors for structural disease is not likely to change management or improve
outcomes.
3. In the evaluation of simple syncope and a normal neurological examination, don’t obtain
brain imaging studies (CT or MRI).
4. Avoid unnecessary use of computed tomography (CT) scans in the immediate
evaluation of minor head injuries.
5. Don’t order sinus CT or indiscriminately prescribe antibiotics for uncomplicated acute
rhinosinusitis.
2) Promote the use of Choosing Wisely resources to the physician community
a. Work with Iowa Medical Society to promote these concepts through the IMS/IHC
Physician Engagement Strategy
b. Develop campaigns targeting high impact initial medical specialties (IM, FP, ER,
Surg)
3) Develop and implement a consumer engagement strategy
a. Promote Choosing Wisely through the Iowa Department of Public Health venues
b. Develop consumer engagement campaign with Wellmark