This effort resulted in more than 70 guidelines addressing both diagnosis and management for a range of clinical scenarios, such as chest pain and syncope, which have already been built into The Johns Hopkins Hospitals’ emergency department electronic medical record system. Preliminary analyses confirm improvements in care delivery — for example, adhering to the chest pain guideline reduced the number of patients with noncardiac chest pain who were admitted to the hospital unnecessarily. All Johns Hopkins Health System adult emergency departments are now implementing these guidelines.

Johns Hopkins’ new qualified provider-led entity status will allow its experts to write criteria that can be used to guide physicians’ use of diagnostic imaging tests as required by the CMS Appropriate Use Criteria Program, beginning with eight clinical priority areas: chest pain, pulmonary embolism, neck pain, low back pain, shoulder pain, hip pain, headache and lung cancer. Johns Hopkins plans to make the criteria available to other care providers across the nation by January of next year, when CMS will require all health care professionals to consult clinical decision support tools when ordering advanced diagnostic imaging tests for Medicare patients.


“While CMS is focused on advanced diagnostic imaging tests, we at Johns Hopkins are keen to ensure best practice across all aspects of medicine and surgery both within our institution and nationally,” says Johnson. “Our rigorous evidentiary literature review coupled with the clinical expertise of the multidisciplinary teams will hopefully refine the practice of medicine so that patients get tests and treatments that add value to their care and benefit from advances in practice more efficiently than they have traditionally.”


About Johns Hopkins’ high value care efforts:
In 2018, the health system’s High Value Care Committee implemented targeted appropriate use interventions for lab and imaging tests. The avoidance of unnecessary testing at The Johns Hopkins Hospital alone resulted in more than $4 million in reduced hospital charges for payers and patients.

In 2016, Johns Hopkins experts organized academic medical centers from across the nation and Canada to form the High Value Practice Academic Alliance. Today, the consortium consists of more than 90 academic medical centers working together to advance high-value medical practice nationally through research, innovation, collaboration and education. The group’s national high-value health care conference, co-directed with the American Hospital Association, is scheduled for Nov. 15–17 at the Baltimore Convention Center. High-value care experts from 80 medical centers across the country will present more than 200 value-based performance improvement initiatives. There will also be many other skill-building opportunities in value-based care.

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