Choosing Wisely in Los Angeles
The most striking impact of Choosing Wisely can be seen when large practices or health systems implement Choosing Wisely recommendations. Here are two local instances of implementation of Choosing Wisely.
Los Angeles County + USC Medical Center: The Los Angeles County Department of Health Services collaborated with UCLA and others on an ABIMF grant to implement Choosing Wisely recommendations. They began in 2015 by eliminating routine preoperative visits and testing prior to cataract surgery. As a result, in addition to a large reduction in unnecessary testing, the average wait time for cataract surgery was reduced by six months.8
Cedars-Sinai Hospital: On a much larger scale, Cedars-Sinai embedded 180 Choosing Wisely recommendations, as well as patient materials, into the electronic medical record in 2013. Alerts were programmed to request that providers reconsider orders that might be unnecessary.9 Implementing Choosing Wisely recommendations across the entire Cedars-Sinai health system saved $6 million in the first year. It was also reported that patients of physicians who followed all the Choosing Wisely alerts had fewer medical complications and left the hospital sooner.10
Locally on the consumer facing side, the Los Angeles County Department of Public Health (DPH) created the Health Care Consumer Protection Unit to reduce harms from needless tests and treatments and to help individuals make informed health choices. The DPH Health Care Consumer Protection Unit includes Choosing Wisely messages and health education materials on its consumer website.