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Providing High-Value Health Care

Eliminating unnecessary tests, requirements and procedures is increasing value of care to patients.

By Paul B. Rothman, M.D.

Dean of the Medical Faculty
CEO, Johns Hopkins Medicine

Date: 01/04/2017

Providing High-Value Health Care

Paul Rothman

As leaders in medical and biomedical education, research, and clinical care, we at Johns Hopkins Medicine understand the need to reduce the costs of health care and optimize patient outcomes and experience by eliminating unnecessary tests, treatments and procedures. In fact, high-value health care is a key focus of both the education and the patient- and family-centered care components in our five-year Strategic Plan. As a result, high-value health care at Johns Hopkins has quickly evolved from smaller programs into a national, collaborative effort. Here are just a few examples of some of our ongoing work.

With the rising costs in health care, the future of medicine rests on our students and trainees. One goal in our Strategic Plan calls for each residency and fellowship program to identify a commonly used test or procedure that is unnecessary, and then design and implement a plan to reduce or dispose of it. Such measures make patient care safer and more cost-effective. As a result of this school of medicine effort, more than 40 clinical initiatives have been embraced by our residency and fellowship programs to date. They are changing the way medicine is practiced.

Another example is an effort led by Johns Hopkins anesthesiologist Stephen Frank that began in 2015 to reduce the number of red blood cell units transfused unnecessarily at Johns Hopkins member hospitals. Although standard protocol has been to automatically infuse two units at a time, one at a time is more appropriate in most cases. All of our hospitals have implemented the Why Give Two When One Will Do? campaign and evidence-based criteria for transfusions, with the goal to reduce blood use by 10 percent across the health system, providing better care for our patients and achieving an annual savings of $2.8 million.

Finally, earlier this year, the school of medicine hosted its first high-value practice research symposium for our own faculty members and trainees that highlighted more than 50 of our initiatives to increase the value of care we deliver to patients. That successful forum showed us just how much we can learn from each other, so we invited all academic medical centers across the country to join us in the High Value Practice Academic Research Alliance, a consortium started by radiologist Pamela Johnson to advance high-value medical practice through research, innovation, collaboration and education.

At the core of this initiative is an annual High Value Practice Academic Research Alliance national research symposium. All academic medical centers are invited to participate in the inaugural symposium, which will be held on Oct. 9, 2017, here in Baltimore and sponsored by the school of medicine. The symposium will include abstract presentations demonstrating evidence of cost reduction in concert with patient care quality improvement, educational lectures from leaders in high-value care and best-practice presentations. Learn more about the symposium, and mark your calendar for this important event.

We are committed to delivering the best care to our patients every day. The onus is on us to provide the right care at the right time, at the right place and at the right cost. By collaborating with other academic medical centers, we can learn from their success stories, adopt best practices and advance our own ongoing efforts to achieve greater value for our patients. Together, we can improve the quality and change the cost of medicine in the United States.

Learn more about JHM’s high-value health care efforts.

With the rising costs in health care, the future of medicine rests on our students and trainees.

- Paul B. Rothman