The Choosing Wisely Massachusetts Campaign

Conversations that inform wise care choices

Welcome to Choosing Wisely Massachusetts

Sometimes good medicine is about what not to do. Choosing Wisely® encourages patients and physicians to talk together about the necessity of various tests and procedures. Numerous medical specialty societies have each developed evidence-based lists of “5 Things Physicians and Patients Should Question.” Full list of societies.

Choosing Wisely is a national program, sponsored by the ABIM Foundation to promote important conversations about appropriate care choices. Consumer Reports has created educational brochures about many of the key tests. Brochures can be used as conversation starters between patient and physician.

Massachusetts Health Quality Partners (MHQP) is partnering with the ABIM Foundation, Consumer Reports and health care stakeholders across the Commonwealth to steward the adoption of Choosing Wisely in Massachusetts. On this website you will find information and materials for patients and families, for health care providers, and for employers and payers. You can also learn how to join this collective effort.

In Massachusetts, health care system and payment reform are changing the way we give, get, and pay for care. Building conversations between patients and providers so they can make wise decisions about when tests or treatments are helpful and when they are not supports better, more affordable care for patients and families in Massachusetts.

Choosing Wisely Massachusetts

Massachusetts Health Quality Partners is leading a multi-stakeholder effort to advance the ABIM Foundation’s Choosing Wisely® campaign in the Commonwealth. The goal of this effort is to encourage physicians and patients to discuss medical tests and procedures that may be unnecessary, and in some instances cause harm. Reducing unnecessary medical care can improve quality for Massachusetts patients.

“The Massachusetts health care environment provides a fertile ground for Choosing Wisely to take hold,” said Barbra G. Rabson, executive director of MHQP. ” As a Commonwealth, we have made it a priority to find ways to achieve high quality and affordable care.”

The Choosing Wisely Massachusetts Campaign will:

  • Build broad public awareness and interest of Choosing Wisely in Massachusestts.
  • Engage providers to integrate Choosing Wisely recommendations and materials in their practice.
  • Engage patients and families to use Choosing Wisely consumer materials to become better informed about the decisions and choices they need to make about their health and health care.
  • Identify ways to engage providers and patients to better communicate in using Choosing Wisely materials.

 

Click here to learn how you can join the campaign.

Things Massachusetts Providers and Patients Should Question

With the guidance of an Advisory Group composed of providers, consumers, employers, payers, state agencies, and professional societies, Choosing Wisely Massachusetts has identified these focus areas:

Imaging Tests for Back Pain (AAFP) 

It seems like getting an X-ray, CT scan or MRI to find the cause would be a good idea.

 

Imaging Tests for Headaches (ACR)

Many with severe headaches want a CT scan or MRI to see if they have a tumor or other serious problem.

 

Early Delivery (ACOG, AAFP)

To hurry a baby’s birth can increase the risk of serious problems for both you and your baby.

 

Colonoscopy (AGA)

Even a very good test can be done too often.

 

Antibiotics for Respiratory Illness in Children (AAP)

Most of the time, children don’t need antibiotics for sore throat, cough or runny nose.

 

Treating Sinusitis (AAFP)

Millions of people are prescribed antibiotics each year for sinusitis.

 

Antibiotics for Urinary Tract Infections in Older People (AGS)

Many older people get antibiotic treatment for urinary tract infections, even though they don’t have symptoms of infection. 

 

Cancer Treatments at the End of Life (ASCO)

Although it is hard to accept, the best thing for you may be to stop treatment for the cancer.

For Patients and Families

In Massachusetts, health care system and payment reform is changing the way we give, receive and pay for care. As a patient or family member you want and need information to understand what to make informed choices about your care.

You want the best care possible and so does your doctor. The Choosing Wisely Campaign offers easy to use educational materials developed with help of Consumer Reports to help you be informed about when tests and procedures may or may not be helpful.

In our changing health care system, patients have an important role to take in asking their doctor questions. Sometimes this can be hard to do. Choosing Wisely shares questions you should ask your doctor before deciding to have a test or procedure.

In Massachusetts, we have an awareness campaign about the following tests and procedures:

Imaging Tests for Back Pain (AAFP) 

It seems like getting an X-ray, CT scan or MRI to find the cause would be a good idea.

 

Imaging Tests for Headaches (ACR)

Many with severe headaches want a CT scan or MRI to see if they have a tumor or other serious problem.

 

Early Delivery (ACOG, AAFP)

To hurry a baby’s birth can increase the risk of serious problems for both you and your baby.

 

Colonoscopy (AGA)

Even a very good test can be done too often.

 

Antibiotics for Respiratory Illness in Children (AAP)

Most of the time, children don’t need antibiotics for sore throat, cough or runny nose.

 

Treating Sinusitis (AAFP)

Millions of people are prescribed antibiotics each year for sinusitis.

 

Antibiotics for Urinary Tract Infections in Older People (AGS)

Many older people get antibiotic treatment for urinary tract infections, even though they don’t have symptoms of infection. 

 

Cancer Treatments at the End of Life (ASCO)

Although it is hard to accept, the best thing for you may be to stop treatment for the cancer.

For Health Care Providers

Choosing Wisely® aims to promote conversations between physicians and patients by helping patients choose care that is:

  • Supported by evidence
  • Not duplicative of other tests or procedures already received
  • Free from harm
  • Truly necessary

In response to this challenge, national organizations representing medical specialists have been asked to “choose wisely” by identifying five tests or procedures commonly used in their field, whose necessity should be questioned and discussed. The resulting lists of “Five Things Physicians and Patients Should Question” will spark discussion about the need—or lack thereof—for many frequently ordered tests or treatments.

This concept was originally conceived and piloted by the National Physicians Alliance, which, through an ABIM Foundation Putting the Charter into Practice grant, created a set of three lists of specific steps physicians in internal medicine, family medicine and pediatrics could take in their practices to promote the more effective use of health care resources. These lists were first published in Archives of Internal Medicine. 

Recognizing that patients need better information about what care they truly need to have these conversations with their physicians, Consumer Reports  is developing patient-friendly materials and is working with consumer groups to disseminate them widely. The Choosing Wisely Massachusetts initiative will focus collective efforts on the following seven topics, however, we encourage physicians and patients to review any of the patient-friendly materials  relevant to specialty areas of interest or health conditions.

Imaging Tests for Back Pain (AAFP) 

It seems like getting an X-ray, CT scan or MRI to find the cause would be a good idea.

 

Imaging Tests for Headaches (ACR)

Many with severe headaches want a CT scan or MRI to see if they have a tumor or other serious problem.

 

Early Delivery (ACOG, AAFP)

To hurry a baby’s birth can increase the risk of serious problems for both you and your baby.

 

Colonoscopy (AGA)

Even a very good test can be done too often.

 

Antibiotics for Respiratory Illness in Children (AAP)

Most of the time, children don’t need antibiotics for sore throat, cough or runny nose.

 

Treating Sinusitis (AAFP)

Millions of people are prescribed antibiotics each year for sinusitis.

 

Antibiotics for Urinary Tract Infections in Older People (AGS)

Many older people get antibiotic treatment for urinary tract infections, even though they don’t have symptoms of infection. 

 

Cancer Treatments at the End of Life (ASCO)

Although it is hard to accept, the best thing for you may be to stop treatment for the cancer.

For Employers and Payers

As an employer, you want your patients to remain healthy and productive.  You provide the best and most affordable insurance coverage for your employees. And you want to provide trusted and reliable information that helps your employees make informed choices about their healthcare, including understanding when tests, procedures and treatments may or may not be necessary.

On this web site, you can find patient materials developed by Consumer Reports in partnership with the ABIM Foundation and over 60 specialty societies. These materials help employees understand when certain tests or treatments are needed and when they are not.  In Massachusetts we are focusing our campaign efforts on the following topics:

Imaging Tests for Back Pain (AAFP) 

It seems like getting an X-ray, CT scan or MRI to find the cause would be a good idea.

 

Imaging Tests for Headaches (ACR)

Many with severe headaches want a CT scan or MRI to see if they have a tumor or other serious problem.

 

Early Delivery (ACOG, AAFP)

To hurry a baby’s birth can increase the risk of serious problems for both you and your baby.

 

Colonoscopy (AGA)

Even a very good test can be done too often.

 

Antibiotics for Respiratory Illness in Children (AAP)

Most of the time, children don’t need antibiotics for sore throat, cough or runny nose.

 

Treating Sinusitis (AAFP)

Millions of people are prescribed antibiotics each year for sinusitis.

 

Antibiotics for Urinary Tract Infections in Older People (AGS)

Many older people get antibiotic treatment for urinary tract infections, even though they don’t have symptoms of infection. 

 

Cancer Treatments at the End of Life (ASCO)

Although it is hard to accept, the best thing for you may be to stop treatment for the cancer.

 

The campaign also includes some general posters that you can download, produce and share. Below see links to these PDFs as well as videos you can post on your intranet or benefit website.

 

Join the Campaign

Join our month-long (February 10-March 13, 2014) collaborative Choosing Wisely Public Awareness Campaign aimed at reducing the unwarranted use of diagnostic imaging in the treatment of lower back pain and persistent headaches. Click here for the Campaign Toolkit, full of activities and suggestions for disseminating information about the Choosing Wisely campaign among clinicians, patients, and healthcare consumers in Massachusetts. The toolkit includes turn-key content, talking points, and resources that you can post on your organization’s website, newsletters, blog posts, and social media outreach.  Please sign up here to receive our free weekly campaign email, updating on the latest activities of our partners and communication activities and content.

 

There are many organizations in Massachusetts that are participating in the Choosing Wisely campaign. MHQP is stewarding our collective efforts by convening an Advisory Group and working with organizations to support their efforts. If your organization is involved with a Choosing Wisely initiative, let us know and we will add you to the growing list of partners below!

Interested in sharing the Choosing Wisely Campaign with your constituents, patients, providers or members? We welcome all organizations to help share Choosing Wisely messages encouraging providers and patients to have conversations about overuse.

Please feel free to download and produce the materials you find on this site. We encourage you to link to this website. If you are interested in embedding Choosing Wisely videos on your website or intranet or co-branding with the Choosing Wisely logo please contact choosingwiselyma@mhqp.org.

List of participating organizations:

Analog Devices

Atrius Health

Blue Cross Blue Shield of Massachusetts

Boston Medical Center HealthNet

Centene

Fallon Community Health Plan

Harvard Pilgrim Health Care

Health Care For All

Health New England

Informed Medical Decisions Foundation

Institute for Clinical & Economic Review (ICER)

MHQP Consumer Health Council

Massachusetts Association of Health Plans

Massachusetts Chapter, American Academy of Family Physicians

Massachusetts Coalition for the Prevention of Medical Errors

Massachusetts Department of Public Health, Bureau of Health Care Quality

Massachusetts Group Insurance Commission

Massachusetts Health Policy Commission

Massachusetts Hospital Association

Massachusetts Medical Society

Massachusetts Office of Consumer Affairs

Massachusetts Society of Radiologists

Network Health

Society for Participatory Medicine

Tufts Health Care Institute

Tufts Health Plan

United Healthcare

Additional Resources

1. Resources about imaging

  • Image Wisely.  This website is focused on radiation safety in adult medical imaging. It offers information and materials for physicians, patients, policy makers, and other stakeholders.
  • Image Gently . This is an information site for parents of children featuring information on radiation safety in pediatric imaging. Produced by the Alliance for Radiation Safety in Pediatric Imaging, this website supports awareness about radiation exposure that children receive when undergoing imaging procedures. The Alliance is a consortium of over 63 specialty societies including the radiologists and pediatricians.
  • RadiologyInfo.org . This site provides Information for patients on the risks of medical imaging procedures like X-rays, CT Exams and MRIs.  It answers key questions in print and video format such as “How much medical radiation is too much?” and “How much medical radiation is safe?” Click here for a printable card to record your medical imaging history.

2. Resources about antibiotic use.

3. Resources about medical education

  • Tufts Health Care Institute (THCI) is a not-for-profit educational organization established as a collaborative venture of Tufts University School of Medicine (TUSM) and Tufts Health Plan (THP). The Institute’s mission is to help physicians and other health care professionals deliver high quality, cost-effective, evidence-based, and patient-centered care—essential goals for health reform. In support of its mission, the Institute develops, delivers, and evaluates a variety of certified educational activities, including live workshops and online courses, for practicing and prospective health care professionals. THCI also partners with other organizations to address their educational needs. THCI’s role in these partnerships can include planning, creating, delivering and evaluating instructional resources and activities.
  • With expert faculty at Tufts University School of Medicine, THCI has developed a series of three Quality archivedEducational Webinars on High, Cost-Effective Imaging. These webinars are accessible on both its public website and itsOnline Learning Campus for residency programs. One of the webinars specifically addresses Spine Imaging Techniques for Lower Back Pain. THCI’s Imaging Webinars include resource lists and links to relevant materials, including the Choosing Wisely Campaign, the American College of Radiology’s Five Things Physicians and Patients Should Question andmaterials for patients on selected tests and treatments, including imaging.
  • Physician Communication Modules: This series of scenario-based communication education modules helps physicians engage their patients in conversations about tests and procedures to question. The scenarios address areas such as patient requests for an MRI for back pain, headache imaging, antibiotics for sinusitis, CT scans for head trauma in children and pre-operative stress tests, and provide specific recommendations on how physicians can engage their patients in conversations about the risks and benefits of these tests or treatments.

4. Free resources for more sensible healthcare decisions, from Consumer Reports.

5. The complete set of Choosing Wisely consumer materials.

 

Contact Us

MHQP has been awarded a two-year grant from the ABIM Foundation to advance the organization’s Choosing Wisely® campaign. The goal of this effort is to encourage physicians and patients to discuss medical tests and procedures that may be unnecessary, and in some instances cause harm. Reducing unnecessary medical care can improve quality for Massachusetts patients.

For more information about Choosing Wisely Massachusetts please contact us at choosingwiselyma@mhqp.org.

About MHQP

MHQP provides reliable information to help physicians improve the quality of care they provide their patients and help people take an active role in making informed decisions about their health care.

Massachusetts Health Quality Partners’ mission is to drive measurable improvements in health care quality, patients’ experiences of care, and use of resources in Massachusetts through patient and public engagement and broad-based collaboration among health care stakeholders.

MHQP is a broad-based coalition of physicians, hospitals, health plans, purchasers, patient and public representatives, academics, and government agencies working together to promote improvement in the quality of health care services in Massachusetts. MHQP was first established in 1995 by a group of Massachusetts health care leaders who identified the importance of valid, comparable measures to drive improvement.