CHOOSING WISELY:STARTING A NEW CONVERSATIONLynn Weekes

CEO NPS MedicineWise

Join the conversation @ChooseWiselyAU #ChoosingWisely

CHOOSING WISELY AUSTRALIA

GOAL: Enhanced quality care reducing unnecessary care

Led by clinicians, patient-care at the centre

Evidence-based

Premise: good communication is central to quality health care

‘Recommendations’ start the conversation

Language is intentional – ‘things you should question’

Canada, US, Denmark, Germany England and Australia

NPS MEDICINEWISE

Independent, non-government, not-for-profit

Empowers people through evidence-based knowledge to make better health choices, informed decisions

Mission driven: improve use of medicines and other health technologies for better health and economic outcomes

Multifaceted programs for health professionals and consumers at a national level

Programs deliver better health outcomes and PBS & MBS savings

NPS MEDICINEWISE’S ROLE

Facilitation role, supporting colleges and societies

Communications strategy

- raising awareness

- stakeholder engagement

- key opinion leaders

- media, website and social media

Implementation

- Synergy with NPS MedicineWise therapeutic programs including reducing use of Proton Pump Inhibitors, opioid use and blood pressure program.

Evaluation

COLLEGE RECOMMENDATIONS

TOP FIVE LIST OF TESTS, TREATMENTS

AND PROCEDURES TO AVOID

CONSUMER RESOURCES

FACILITATING CONVERSATIONS

Consumer resources to match college and support college recommendations

Education campaign

•     Raise awareness, main stream media campaign, website

•     Strong media coverage; TV, radio, magazines, public service messages

•     Public awareness of the issue of unnecessary care

•     Social media campaign •     Consumer resources (includes decision aids), website

•     Consumer organisations actively support resource development & implementation

•     Develop partnerships with consumer organisations to engage groups in implementation activities

•     Features in partner newsletters, websites, social media

•     Consumers and general public gain confidence in the initiative

•     Promote increased shared decision making

•     Increased frequency of discussion on unnecessary care

•     Incorporation of shared decision making in practice

•     Promote adoption of l ists in cl inical practice

•     Better fit between need and care •     Reduced unnecessary care

•     Promote patient activation •     Use of decision aids •     Consumer initiation of conversation, “do I really need that test?’

Consumer engagement and acceptance

Consumer activation and change in cl inical practice

COLLABORATION IS KEY

Advisory group

- Associate Professor Richard King, AM, Senior Medical Director at Monash Health (Chair)- Associate Professor Meera Agar, Director of Palliative Care, Braeside Hospital, HammondCare- Dr Matthew Anstey, Staff Specialist Intensive Care Physician, Sir Charles Gairdner Hospital - Melissa Cadzow, Consumer Representative- Darlene Cox, Consumer Representative - Associate Professor Adam Elshaug, Health Care Policy, Menzies School of Public Health- Dr Rob Hosking, General Practitioner, The Elms Family Medical Centre - Associate Professor Richard King, AM, Senior Medical Director at Monash Health- Elizabeth Koff, A/Deputy Secretary, Strategy and Resources, NSW Health - Sally Marotti, Clinical Pharmacy Team Leader & Intensive Care Specialist Pharmacist, The Queen

Elizabeth Hospital- Dr John Slavotinek, Consultant Radiologist, Repatriation General Hospital, Flinders Medical Centre

Regular college representative panel discussions

SECTOR WIDE COLLABORATION

WHY WE NEED CHOOSING WISELY

Not all tests add value

Clinical experts leading debates about budget allocations

Decisions based on best evidence available

Consumers need resources to assist the conversation with health professionals

There is pressure on practitioners to cover all clinical possibilities

Long term sustainability of the health care budget

Greater accountability

CRITICAL SUCCESS FACTORS

Health profession-led: establishes credibility and trustworthiness

Development and ownership of lists is driven by colleges

Arms length from payers and government

Consumers are part of the discussion

Language: Quality and reducing risk of harm and waste resonate with clinicians and consumers

‘One message but many voices’

NEXT STEPS

Wave II: more recommendations, more resources, more colleges, more supporters

Colleges onboard for wave II so far:

- The Royal Australian and New Zealand College of Ophthalmologists (RANZCO)

- Australian College of Nursing (ACN)- College of Intensive Care Medicine (CICM)- Australian and New Zealand Intensive Care Society (ANZICS)

To find out more or become involved:

twitter.com/ChooseWiselyAu

choosingwisely@nps.org.au

http://www.choosingwisely.org.au