April 6, 2015

Health care quality, cost and outcomes are more important than ever. OHSU is a leader in the regional and national dialogue about health care reform, so when the Oregon Medical Association recently announced a statewide competition called Choosing Wisely in Oregon, OHSU faculty members, students and staff responded.

Choosing Wisely is an initiative of the American Board of Internal Medicine Foundation. As described by ABIM, it "aims to promote conversations between providers and patients by helping patients choose care that is: Supported by evidence, not duplicative of other tests or procedures already received, free from harm and truly necessary." The OMA challenged health care providers, medical groups and health professional schools across Oregon to submit proposals for implementing Choosing Wisely in their organizations.

The following three OHSU projects were chosen as awardees in the education category. Congratulations to all the participants!

Kim Irish, M.S., HCM, CPHQ, quality manager for the OHSU School of Medicine's Graduate Medical Education division, submitted a proposal describing a GME competition to increase awareness of and facilitate implementation of Choosing Wisely. OHSU house officers will form teams and design a project around one Choosing Wisely recommendation from a relevant specialty society list. Project abstracts will be submitted to the 3rd Annual OHSU GME Performance Excellence Poster Symposium in 2016. Irish was interviewed for the project and featured on the national Choosing Wisely website. OHSU residents and fellows are quickly becoming leaders in the quality movement; read more about this GME "ripple effect."

Ryan Palmer, Ed.D., Benjamin Schneider, M.D., and Fran Biagioli, M.D.,* faculty members in the School of Medicine Department of Family Medicine, submitted a proposal to further pilot the Telemedicine Objective Structured Clinical Exam (TeleOSCE) project. Using a simulated patient encounter, the TeleOSCE gives medical students hands-on practice of communication skills important for cost- and resource-conscious care. The Choosing Wisely "5 Questions" are also incorporated into the simulation experience. The actor portraying the remote patient is provided a script to ensure learners address the questions.

Medical students Kelsey Priest, MPH and Emily Harvey, M.S., with faculty members Paul Gorman, M.D., Peter Sullivan, M.D., David Pollack, M.D., and Cliff Coleman, M.D., MPH,* submitted a proposal to incorporate Choosing Wisely into the OHSU School of Medicine's undergraduate medical education curriculum, YOUR M.D. During the preclinical education period, students will learn to think critically about the root causes of unnecessary care using examples from the Choosing Wisely lists that correspond to each educational system block. Additionally, the proposal describes ethics curriculum integration, specifically around discussions of non-maleficence, resource scarcity, equity and justice.

Read more about all the winners and their projects.

Particulars:

• Dr. Biagioli is professor of family medicine, OHSU School of Medicine
• Dr. Coleman is assistant professor of family medicine, OHSU School of Medicine
• Dr. Gorman is associate professor of medical informatics and clinical epidemiology, OHSU School of Medicine
• Dr. Palmer is assistant professor of family medicine, OHSU School of Medicine
• Dr. Pollack is professor of psychiatry, OHSU School of Medicine
• Dr. Schneider is assistant professor of family medicine, OHSU School of Medicine
• Dr. Sullivan is clinical associate professor of medicine, OHSU School of Medicine