Provider, Patient, and Health System Effects of Provider Commitments to Choose Wisely

Clinicians are often influenced by high-pressure practice environments to order services that do not improve patient outcomes or can cause patients unnecessary harm. The proposed intervention, Committing to Choose Wisely (CCW), will ask clinicians to commit to avoid low-value services and provide resources to support adherence to this commitment.

Start date: March 1, 2016

End date: February 28, 2019

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The project will examine behavioral economic strategies for decreasing the use of low-value clinical services as listed in the Choose Wisely campaign, a large-scale, evidence-based effort to identify and raise awareness of healthcare services that may be of little value to patients.

The intervention, which extends across two large health systems, will generate quantitative data from clinical automated data and focused medical record review data to examine rates of order before and after the intervention, as well as qualitative data from surveys and interviews of both clinicians and patients to determine the effects of the intervention on their decision-making and experiences.

Adler-Milstein’s role includes monitoring the implementation of the intervention, assembling the clinical claims dataset and assisting in the interpretation of quantitative results. Krupka will contribute by providing insight from behavioral economics to help design the intervention, monitoring the implementation of the intervention, and supporting the analysis and interpretation of qualitative results.

The results of this project will enable clinicians to decrease the use of low-value services by making available tools and resources that can easily integrate into clinical practice with minimal impact on clinician time and patient-clinician communication


The Patrick and Catherine Weldon Donaghue Medical Research Foundation, $11,860 and $7,682.

The funding is part of a larger $600,000 grant awarded to the U-M Institute for Healthcare Policy and Innovation and the Department of Internal Medicine.