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Reporting mechanisms also have im-


proved, Dr. Salman added. When PQRS began, for example, physicians had to input codes and report on a daily basis. Now doctors can report months of data retrospectively on most measures. CMS acknowledges some barriers and


early problems with the programs, but says the agency has consistently expand- ed the PQRS and e-prescribing programs and reporting options. Keller family physician Gregory M.


Fuller, MD, says that kind of streamlin- ing is critical, especially for smaller prac- tices like his.


As a certified medical home, North


Hills Family Medicine already achieved meaningful use and participates in Medi- care e-prescribing and PQRS. Even with just 4 percent of patients in Medicare, the three-physician group does not want to leave any dollars on the table. “Most physicians are going to strive to meet these criteria, and we need to make sure the process is simpler and cleaner so they can achieve that,” said Dr. Fuller, also a member of TMA’s Coun- cil on Health Care Quality. “Physicians with a large Medicare population stand to lose a lot of dollars. For others, the question is whether that penalty is go- ing to be egregious enough for them to consider dropping Medicare.”


date, 25 medical specialty societies have identified and created lists of more than 130 tests and procedures they say are overused or inappropriate. The $50,000 grant will allow TMA


to promote Choosing Wisely to Texas physicians in collaboration with county medical societies, the Texas Osteopathic Medical Association, and state medical specialty societies. The grant runs from April 1, 2013, to March 31, 2015. A recommendation for TMA’s formal involvement in the campaign goes be- fore the House of Delegates in May, after receiving initial approval from the Coun- cil on Health Care Quality and Board of Trustees.


TMA wins grant to promote “Choosing Wisely” campaign


The Texas Medical Association, partner- ing with the TMA Foundation, is among 21 state and specialty medical societies and regional health collaboratives that won grants from the ABIM Foundation to advance the Choosing Wisely cam- paign. Support for the grant program comes from the Robert Wood Johnson Foundation. The program encourages physicians and patients to discuss the appropriate- ness of medical tests and procedures that may be unnecessary or even harmful. To


TMA continues to develop education- al materials and clinical tools to help ready physicians for upcoming quality improvement, patient safety, and per- formance measurement challenges, and views Choosing Wisely as another po- tential vehicle. (See “Choosing Wisely,” December 2012 Texas Medicine, pages 25–29, or online at www.texmed.org/ Template.aspx?id=25869 .) Choosing Wisely gained momentum since it launched in April 2012 with lists from nine specialty societies. In Febru- ary 2013, 17 physician-led organiza- tions announced new lists of tests and procedures to question. Campaign part- ners include the American Academy of Family Physicians, the American College of Cardiology, the American College of Radiology, the American Academy of Pediatrics, and the American College of


Obstetricians and Gynecologists, among others.


Individual specialty societies devel-


oped the recommendations using the most current evidence about manage- ment and treatment options within their specialty. Examples include:


• Don’t order sinus computed tomog- raphy or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis. (American Academy of Allergy, Asthma & Immunology)


• Don’t obtain imaging studies in pa- tients with nonspecific low back pain. (American College of Physicians)


• Don’t schedule nonmedically indi- cated inductions of labor or cesarean deliveries before 39 weeks, 0 days of pregnancy. (American College of Ob- stetricians and Gynecologists)


• Don’t automatically use computed to- mography scans to evaluate children’s minor head injuries. (American Acad- emy of Pediatrics)


Consumer Reports also is a partner in Choosing Wisely to engage patients in the effort. More information on the campaign and the lists is available at www.choos ingwisely.org/. n


Amy Lynn Sorrel is an associate editor of Texas Medicine. You can reach her by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at amy.sorrel@texmed.org.


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