Evidence-based medicine, applications of
A State-led accountable care collaborative provides comprehensive, coordinated care to Medicaid beneficiaries through primary care medical homes, reducing use of inpatient, imaging, and emergency department services, and generating estimated savings of $6 million for the State.
A mobile clinic provides screening, education, coaching, and health navigation services to residents of four underserved communities, leading to the identification of many previously undetected chronic conditions, better blood pressure control, and a substantial return on investment.
The State of Minnesota uses financial rewards and penalties to fund nursing home–initiated quality improvement projects through a competitive bidding process, leading to improvements in the quality of care.
A primary care medical home for patients with disabilities and complex, chronic medical conditions emphasizes patient engagement and care coordination among medical specialties and social service providers, leading to enhanced access to care, better self-management skills, more days of good health, fewer hospitalizations, and lower costs.
A children's hospital uses an enterprise data warehouse to assist multidisciplinary teams in identifying and addressing opportunities to improve quality, leading to better adherence to evidence-based guidelines, less unnecessary care, and significant cost savings.
A low-cost, community-based, culturally tailored education program led by a bilingual nurse practitioner helped Korean immigrants with type 2 diabetes improve self-management behaviors and achieve better control of the disease.
A city health department encourages public and private maternity hospitals to voluntarily adopt various policies to support new mothers who choose to breastfeed exclusively. The program has attracted many participating hospitals, won broad support within the medical community, and increased the proportion of new mothers who breastfeed exclusively during their hospital stay.
An online clinic enhances access to and reduces the costs of care for 40 minor health problems that can safely be handled without a face-to-face visit, generating significant time savings and positive feedback from patients, physicians, and payers.
A multiagency, cross-disciplinary mayoral task force develops and supports implementation of policies and programs to reduce prescription painkiller abuse and its associated problems in New York City—efforts that have prompted many public and private hospital emergency departments to adopt recommended prescribing guidelines, resulting in preliminary indications that fewer opioid painkiller prescriptions are being written and filled in some of the city's emergency departments.
Multiple pieces of legislation in Washington state are starting to have an impact on use of shared decisionmaking in clinical practice, including a mandated demonstration project, recognition of use of decision aids as informed consent in malpractice cases, and formation of a learning collaborative.