The Institute of Medicine estimates up to 30 percent of healthcare delivered in the U.S. is unnecessary and may cause harm. For years, it has been Intermountain’s focus to deliver best-practice care and eliminate care that is unnecessary and potentially harmful. Many teams are working on best-practice care, but Intermountain determined the need for a utilization management committee to identify and help curb the use of high volume tests and medications that had no evidence to support them.

The Key Objective: to Identify High Volume but Unnecessary Tests and Prescriptions

The Primary Care Clinical Program looked at national guidelines and recommendations—patterned after the Choosing Wisely® campaign of the American Board of Internal Medicine Foundation—as well as Intermountain data to develop Choosing Wisely® care process models for adults and pediatrics, resources for decision making at the point of care, and patient education. Focus areas prone to overuse or misuse include the following:

  • Imaging: Avoid imaging tests in acute low back pain unless there are red flags for serious pathology or injury.
  • Lab tests: Limit lab tests to those with an evidence base that supports their use.
  • Medications: Use antibiotics and other drugs only when truly necessary; choose generics when possible.
  • Preventive care: Encourage preventive care visits—but not unnecessary tests.
  • Under-used care: Don’t skip the important, evidence-based tests and treatments.

Choosing Wisely® reports to gauge progress are updated monthly online in the reports center and provided to providers quarterly in print.

The Results: Improve Care, Save Money, and Educate Patients

Intermountain expects significant savings to both the healthcare system and to patients when unnecessary tests and prescriptions are avoided and the focus is on proven effective treatments. As patients are educated, they are more likely to follow the recommendations.