1. Wendy Levinson, MD
Professor of Medicine, University of Toronto
Chair, Choosing Wisely Canada
Welch Public Health Conference 2014
October 7, 2014

2. Total health expenditures as percentage of gross domestic product (1970-2011)

3. Berwick D. JAMA. 2012.

4. Better to do something than nothing
The patient wants it
I’ve always done this
New tests are good $$
I don’t want to get sued
Better to do something than nothing
Please make the first one come in at 1 oclock and then clockwise. This is how all of them work—please ask karen and see others-Done
Referring doctor wants it

5. Choosing Wisely Canada (CWC) is a campaign to help physicians and patients engage in conversations about unnecessary tests, treatments and procedures, and to help physicians and patients make smart and effective choices to ensure high-quality care.

6. History of the campaign
Choosing Wisely® campaign began in 2012 in US; 70 medical societies are participating
Choosing Wisely Canada launched in April 2014
More than 30 national specialty societies engaged and at various stages of recommendation development
Choosing Wisely® efforts are also present in countries like Australia, Denmark, England, Germany, Italy, Japan, Netherlands, New Zealand, Switzerland, Wales
Change title to History of the campaign

7. Campaign Approach Physicians Patients Media Stakeholders
Societies develop lists
Disseminate through multiple channels
Physicians
Develop patient materials
Disseminate broadly through multiple channels
Patients
Coordinated approach toward media
Multiple voices, a common message
Media
Work through health care stakeholder organizations to implement and support adoption
Stakeholders

10. Putting recommendations into practice
Make a new slide for this. I want a visual of putting the recommendations into practice and not a list of the groups. Maybe look at visuals for knowledge translation or something; move cedar sinai slide after this new one.
Also I would like a new slide just ahead of this one to illustrate false positive results.

11. Cedars-Sinai Blind Spot Monitor: CW Embedded in CPOE

12. Better to do something than nothing
The patient wants it
How we are taught
New tests are good
Preemptive ordering
Better to do something than nothing
Lack of feedback
Demonstrate thoroughness

13. Choosing Wisely Australia Choosing Wisely Canada Doing more does not mean doing better (Italy) Choosing Wisely Japan Choosing Wisely – The Netherlands Smarter Medicine (Switzerland) Choosing Wisely (U.S.) Prudent Healthcare (Wales)

14. Principles of a Choosing Wisely Campaign
Physician led
Patient-focused
Evidence-based
Multi-professional
Transparent

15. Reduce unnecessary care, harm and waste
Health care systems
Clinical practice
Physicians & patients
Reduce unnecessary care, harm and waste
Partnerships + Integration
Shared Decision Making + Implementation
Awareness + Education + Engagement