ACEP Prepares List for Choosing Wisely Campaign

After an extensive look at ways to provide cost effective care to emergency department patients, the American College of Emergency Physicians has developed a list of five recommended tests and procedures that may not always be necessary to provide quality emergency care.

ACEP will unveil its list of recommendations as part of the “Choosing Wisely”® campaign during the ACEP13 annual meeting, Oct. 14-17, in Seattle, Washington.

The goal of the campaign, part of a multi-year effort of the American Board of Internal Medicine (ABIM) Foundation, is to promote conversations between physicians and patients about utilizing the most appropriate tests and treatments, and avoiding care whose harm may outweigh the benefits. Since launching in April 2012, more than 80 national, regional and state medical specialty societies, health collaboratives and consumer groups have become “Choosing Wisely” partners.

More than 30 medical specialty associations and societies will release their lists over the next year, starting in September 2013.

ACEP had previously declined participation in the “Choosing Wisely” campaign because of the challenges of this approach with the unique nature of emergency medicine, liability concerns, and a potential harm to physician reimbursement.

The College meanwhile remained steadfast in its commitment to cost-effective care and a high-value health care system, and in 2012, Immediate Past President Dr. David Seaberg appointed a Cost Effective Care Task Force, chaired by Dr. David Ross. The Task Force was charged with considering tests, processes and procedures with little or no value to emergency care that might represent meaningful cost savings if eliminated.

In a report to the ACEP Board of Directors in February, Task Force member Dr. Jay Schuur said that their Delphi panel and ongoing member surveys have suggested that a number of tests will meet the criteria of the “Choosing Wisely” campaign. They also determined that these tests would not increase the physician’s liability, and would not negatively impact payments for emergency physicians.

After being reviewed by experts, emergency medicine leaders, and the ACEP Board, the report’s data indicated that it would be appropriate for emergency medicine to participate in the campaign. ACEP officially joined the campaign in February 2013.

In  July, the Delphi panel proposed a list of recommendations that was adopted by the ACEP Board of Directors. The list will be announced at ACEP13 and communicated to the membership in multiple publications.

ACEP continues to initiate, develop and adopt a variety of strategies that strive to improve patient care and provide meaningful cost savings. 

“We are dedicated to ensuring that our specialty can be leaders in health care system efficiency while maintaining a high quality of emergency care and patient safety,” said ACEP President Dr. Andrew Sama.

In order for there to be a serious reduction in unnecessary tests and costs of defensive medicine over time, meaningful liability reform and safe harbors are vital. ACEP is encouraging ABIM and its campaign partners to lend their voices to the need for medical liability reform. This remains a top priority in ACEP’s advocacy agenda.

Additionally, the College is working on other significant and impactful efforts, including proposing an elimination of the 3-day-stay rule and better management of transitions of care.

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