Overuse of low-value and unnecessary treatments, screenings, and procedures is an epidemic within the healthcare industry.

In a follow-up to their initial report in February 2018, the Washington Health Alliance examined the delivery of 48 commonly overused or unnecessary services across a sample of 2 million patients.

“We cannot continue to deny the problem of waste in health care.” – Nancy A. Giunto, Executive Director of the Washington Health Alliance

Their findings showed that 47% of these services were of low-value or unnecessary, resulting in medical waste spending that totaled $341 million.

Read the full report here: First, Do No Harm: Calculating Health Care Waste in Washington State

What are overused services?

The Alliance categorizes low-value healthcare services as, “medical tests and procedures that have been shown to provide little benefit in particular clinical scenarios and in many cases may have the potential to cause physical, emotional, or financial harm to patients.”

Some of the most commonly overused or low-value services include:

  • Annual EKGs and other cardiac screening for low-risk individuals
  • Eye imaging tests for people without significant eye disease
  • Preoperative tests and lab studies prior to low-risk surgery for low-risk individuals
  • Too frequent screening for cervical and prostate cancer and vitamin D deficiency

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How overuse affects patients

According to the report’s author, Susanne Dade, when unnecessary or low-value services are applied in healthcare, there is an opportunity to “create the very real potential for harm to patients — physical, emotional, and financial harm.” Here’s how.

  • Physical harm — Discomfort from screenings such as those for cervical cancer and prostate cancer.
  • Financial harm — Patients in a fee-for-service healthcare environment incur significant additional costs for each treatment or screening they receive.
  • Emotional harm — The ripple effect of both financial and physical harm from unnecessary treatments can cause significant stress and anxiety in patient lives.

“While harming patients is not intentional, it is particularly troublesome when it results from tests, procedures, and treatments that were unnecessary, to begin with, and known by the medical community to be overused,” says Dade.

Combating waste with evidence and dialogue

A commitment to evidence-based care practices and better communication with patients are at the heart of a solution to waste in healthcare.

Nancy A. Giunto, Executive Director of the Washington Health Alliance, says:

“Physicians and patients need to practice shared decision-making and have conversations about appropriate medical care that is both necessary and evidence-based.”

The problem is, traditional healthcare systems don’t allow patients and providers the time or resources to have a meaningful dialogue about their care. And, it’s difficult to hold all providers to the same standards of evidence-based care.

How on- or near-site clinics solve the problem

An on- or near-site clinic offers layers of patient protection from overuse and waste in healthcare. Here’s how:

  • Shared Decision-Making — Patients and providers have the time and resources necessary to form meaningful connections and participate in shared decision-making about the care being delivered.
  • Unlimited, Free, Primary Care — Primary care — which includes most of the 48 services the Alliance found to be commonly overused — is free and unlimited. For the most common healthcare services, patients are never at risk of financial harm.
  • Coordinated Care — When a patient’s needs extend beyond the clinic, providers work to find low-cost, high-quality care that aligns with a patient’s financial abilities.
  • Evidence-Based Care — Providers are trained to practice evidence-based care and receive follow-up education to ensure the treatments and services they recommend reflect the most up-to-date medical practices.

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