Minneapolis VA High Value Care (HiVAC) Initiative.

Wilt TJ, Partin MR, Koeller E, Velasquez TL, Greer NL, Lillie SE, Danan ER, Taylor BC. Minneapolis VA High Value Care (HiVAC) Initiative. Poster session presented at: Preventing Overdiagnosis Annual Conference; 2015 Sep 1; Bethesda, MD.

Objective: High value care is defined by clinical benefits that clearly justify the harms and costs of health care interventions. The objective of the Minneapolis VA HiVAC initiative is to bring together researchers, clinicians, educators, policy makers and patients to improve the implementation of Veteran-centered health care through defining, discovering and delivering high value care with an emphasis on reducing low value care. Methods: The Minneapolis HiVAC initiative is a multidisciplinary collaboration utilizing diverse methodologies and projects at the intersection of health care research, practice, policy and education to deliver high value health care. Results: In 2014-15, the Minneapolis VA HiVAC initiative completed several projects that improved health care value. Our VA Evidence-based Synthesis Program, together with the American College of Physicians, identified the harms and lack of evidence for benefit of routine screening pelvic examinations in asymptomatic women. Our findings led to recommendations against this practice. We defined a "Value Framework" to deliver high value cancer screening according to screening "intensity" and applied those concepts to develop best practice advice for implementation of high value cancer screening. Members of our HiVAC initiative have also discovered new ways to implement these findings by creating shared decision-making tools to improve prostate cancer screening decisions. Future projects will offer evidence to guide decisions on discontinuing cancer screening, inform delivery of high value cancer screening across racial/ethnic minorities, provide practice suggestions for clinicians when evidence is insufficient and develop guidance for high value care for individuals with type 2 diabetes. Conclusions: The Minneapolis VA HiVAC initiative is engaged in collaborative patient-centered research, education and policy to help patients and their clinicians choose wisely about health care options and improve the delivery of high value health care.