Maine Quality Counts: Helping Patients “Choose Wisely”


Maine Quality Cares logo

Maine Quality Counts (QC) is a regional healthcare collaborative dedicated to transforming health and healthcare in Maine. Formed in 2003 and incorporated in 2006, QC provides leadership, advocacy and support for improving care. Its 75+ members are major care delivery organizations, payers and employers, as well as individuals, providers and associations.

In 2013, as part of its commitment to meaningful engagement of consumers in care transformation, QC began utilizing the Choosing Wisely campaign, an initiative designed to promote conversations between clinicians and patients to avoid unnecessary tests, treatments, and procedures. QC first incorporated Choosing Wisely into its Patient Centered Medical Home initiative as part of the Aligning Forces For Quality (AF4Q) project. The strategic emphasis was on patient engagement and establishment of patient advisory groups and patient advisors at the practice level. Four pilots in primary care practices had great success in recruiting patient advisors to work with the practices specifically on creating tangible ways to engage patients in their own care through Choosing Wisely.

Later, QC integrated and aligned Choosing Wisely into its work in the Northern New England Practice Transformation Network (NNE-PTN) as part of the Transforming Clinical Practice Initiative. QC broadly distributed a letter highlighting how evidence-based tools on low back pain can help practices successfully implement one of the PFE Metrics and achieve MIPS Improvement Activity points.

Choosing Wisely site visit

Amanda Banister, a NNE-PTN practice facilitator, remembers guiding a newly enrolled orthopedic practice in mid coast Maine to the link to Choosing Wisely. Less than a day later, the provider sent her an email saying “The Choosing Wisely link is now on our website. Great resource for our patients!” The practice then implemented use of rack cards on low back pain, opioid use, and advanced imaging. They plan to place the 5-Questions posters, available through Choosing Wisely, in every exam room throughout the clinic and a video will be played in the waiting room – preparing patients to be active, informed partners in care.

Based on her experience with a wide variety of specialty practices, Amanda reflects on why the Choosing Wisely tools make sense for busy practices: “Practices don’t have to re-invent the wheel. An individual practice may think it is unique but using already-available credible tools that are health literacy based can save a lot of time. The tools are flexible and can be adapted to meet the needs of different patient populations. And there are lots of tips and advice on implementation as well.”

With the support of NNE-PTN, more practices across NNE-PTN are implementing Choosing Wisely. Because of the efficacy of this approach to PFE, practices will experience improved outcomes and patient satisfaction, reductions in unnecessary testing, and cost savings – important goals for patient care.