Low-value care has always been a matter of concern for the healthcare industry. The latest “Choosing Wisely” campaign has unearthed the fact that imaging and a few more tests can offer scope for reducing the same. However, proper action, and not mere words will decide the fate of low-value care in the medical care domain. Experts have argued in favor of taking action instead of dwelling on ideas alone.
The Campaign
The “Choosing Wisely” campaign was launched in the year 2012. It chose as many as 626 services that may have contributed to the trimming down of U.S healthcare spending. This assortment included 26.8% imaging facilities and 24.9% laboratory studies. Many of these further had an association with other downstream services.
In the Dec 3 edition of JAMA Internal Medicine, the researchers noted that these low-value services did not decline considerably throughout the 9 years of the study. According to the researchers, the decline has only been modest.
Based on these findings, the team emphasized the need for noticeable regional, local, and national level efforts from the multi-stakeholders to reverse the situation. According to the team, the desired outcomes would remain out of reach without the wholesome participation of the stakeholders.
Ishani Ganguli, who is an MD and MPH with the coveted Harvard Medical School, the campaign might have been a pillar in finding the reality but never the solution to it. Ground levels actions to address the problem can only raise the pace of decline of low-value care. This is critical for the medical care sector to operate at its optimum and best capacity.
The Recommendations
Recommendations of “Choosing Wisely” have changed from time to time. The team figured out these periodic alterations and explained the different opportunities each change provided. They have meaningfully decoded all the 626 recommendations till March 2021, from the Physicians’ Society, U.S.
The list of recommendations often had two items common in them. One was imaging services, and the other was lab studies. The list had services availed by the patients with chronic health conditions, and the ones with early symptoms of critical diseases.
The authors further noted that many of these services were not critical for revenue generation. However, the low-cost services indicated a sharp, rising trend of low-value services. 44.7% of the campaign’s recommendations indicated a direct connection of these services with potential harm. Additionally, 62% of the low-cost services could trigger additional services.
From Ideas To Action
Much like the warnings of Ganguli and team, a team of three editorialists also mentioned that mere words will fall short of the requirements. According to them, an updated list of services will not be adequate for handling the real crisis.
Niloofar Latifi is an MD of Johns Hopkins University School of Medicine. Latifi and the co-authors boastfully mentioned in their Dec 6 article that it is time to take objective action. Pursuing the findings revealed by the campaign will no longer do any good.
Multilevel implementation of corrective strategies regarding value-based care is what the medical care sector needs today. These changes should find their way into the educational and structural foundations of the system as well.
The team exemplified this by offering further insight. They suggested that the importance of reduction of low-value services should be a part of the undergraduate and postgraduate curriculum. Latifi et al. also suggested the involvement of tools like auditing, feedback, etc to keep the process accountable and pilferage-free.
The editorialist further mentioned that the medical care sector should extend incentives to those not offering low-value services. Hospitals and other caregiving institutions should remain accountable for the services they offer or recommend.
Medical care services are critical for health. The best yet affordable services are hard to find. However, at Sepstream®, we believe in catering to the most at the minimum. In simple words, we keep our services upgraded yet affordable. Offering uncompromised and top-notch imaging services to the maximum number of people has always been our motto.