The case for using evidence-based tools such as clinicalpractice guidelines (CPGs) has a wealth of statistics to back itup. (Photo: Shutterstock)

It's unlikely that Americans have ever been more tuned-in todiscussions on what it means to make data-driven, medically soundhealth care decisions. As the Corona Virus dominates the world'sattention, a new white paper outlines why it matters thatevidence-based guidelines are followed in health care—especially tothose who paying for that care.

The new paper, "What Employers Need to Know about Evidence-BasedMedicine and Clinical Guidelines," was released by ConnectionsHealth Care Cost Containment, a consulting firm that blendsexpertise from both the clinical and financial side of health caremanagement.

Related: Evidence-based medicine: Employers also have a roleto play

According to the report, providers are still lagging behind inusing the best evidence-based practices when it comes to deliveringhealth care. "While evidence-based medicine (EBM) is the goldstandard taught to all clinicians and is widely accepted asimportant to drive superior outcomes, day to day decision-making inhealth care is slow to evolve from 'opinion based' or'experience-based' to those based on sound scientific evidence,"the report says in its introduction.

Not only better health, but lower costs

The case for using evidence-based tools such as clinicalpractice guidelines (CPGs) has a wealth of statistics to back itup. The report noted that a recent study estimated that ifproviders in the United States followed six heart failure guidelinerecommendations, approximately 68,000 deaths a year could beprevented.

The report also discussed data from the United States' Agency for Healthcare Research and Quality (AHRQ)showing that between 2010 and 2014, there was a seventeen percentdecline in hospital-acquired conditions (HACs) as a result ofefforts to improve quality of care and reduce adverse events. Thisemphasis on quality is estimated to have saved $19.8 billion inhealth care costs over a four-year period—underlining why employersand health insurance purchasers have such a stake in evidence-basedmedicine

However, the researchers said, much more can be done. "Whilelives have been saved and costs dramatically lowered through theadherence to CPGs, the United states is not currently achievinganything close to our maximum potential," the Connections reportsaid.

What is blocking adherence to evidence-based medicine?

The Connections report points to two areas that holding upbetter compliance with CPGs. One is simple human nature: physiciansand other providers are often more likely to trust their trainingand experience than new guidelines, even if the evidence supportsthose guidelines.

"Many physicians consider CPGs as inhibiting their professionalautonomy and flexibility, as well as depersonalizing thephysician-patient relationship," the report said. "They may nottrust their ability to implement and stay up to date due to timeand limited resources."

The report said payers have the ability to push for betteradherence to CPGs and outlined several strategies that employerscan used to improve quality and reduce costs. These strategiesinclude:

• Adjusting health plan language: Language inhealth plan contracts that links "medical necessity" or "usual orcustomary care" gives providers broad latitude for making medicaldecisions. "Employers should consider stronger health plan languagesuch as, "payment will be considered for services that are based onEvidence-Based Medicine Guidelines," the report said.
• Empowering and educating health plan members:The report calls for empowering patients as partners in health carequality efforts. "Educate health plan members to evidenced-basedmedicine and its importance in making sound health care-relateddecisions," the report said. It suggested educational efforts suchas a "Get with the Guidelines" campaign.
• Next-generation medicalmanagement: The report also promoted what itcalled Next Generation Medical Management, which it said wouldensure that the right patients gets the right care at the righttime, for the right price.

Read more: 

• Health care spending continues to rise, despitecost-saving strategies
• Health care data analytics: true meaning,actionability and value
• Collaborative program to link health care providersfinancially to patient outcomes