emergency department with syncope, insignificant trauma, and a normal neurological evaluation.” “These are topics that physicians
already know. But it’s one of those things that, as we get pushed to see more patients in less time, there is a potential to get lax because it’s easier to click ‘CT-head’ on an EMR (elec- tronic medical record), versus sitting on a stool and discussing it with the patient. By the time I order the CT and wait for the read, I could have spent two minutes talking to the pa- tient, he or she could be back home, and we may not need to explain it next time,” he said. “All doctors are pushed on time constraints. This ac- tually helps save time and money, and it’s better medicine.”
STATEWIDE ATTENTION TMA’s work has caught the state’s at- tention, too. James Cooley is a research special-
ist with the Health Policy & Clinical Services Quality Unit of the Texas Health and Human Services Com- mission (HHSC). The agency adopted Choosing Wisely after the 2011 legisla- ture created and tasked the Physician Payment for Quality Committee (tma
.tips/PayQualityCommittee) with de- termining the 10 most overused ser- vices performed by Texas Medicaid physicians. During that process, he says, HHSC staff reached out to TMA, knowing it had a grant. “The initiative greatly influenced
recommendations by the Physician Payment for Quality Committee,” he said. “The appeal of Choosing Wisely is that it came from doctors them- selves as a quality and safety effort. It was physicians offering advice to their peers via respected specialty societies. HHSC staff welcomed the opportunity to work with the TMA on a project to improve patient care that was physi- cian-led.” Mr. Cooley adds Choosing Wisely-
will be “a useful resource” in an up- coming analysis of potentially avoid- able ancillary services. The initiative
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March 2015 TEXAS MEDICINE 55
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