Five Ways to Reduce Emergency Care Costs

An expert panel of emergency physicians from a healthcare system in Massachusetts identified 17 tests, treatments, and disposition decisions that are expensive, frequent, and of little or no benefit to most patients. These items were included in a survey of 283 emergency medicine clinicians from the same system. Based on the responses, the panel created a top-five list of actions to reduce the cost of emergency care:

1. Do not order computed tomography (CT) imaging of the cervical spine for patients who do not meet the National Emergency X-Radiography Utilization Study (NEXUS) criteria or the Canadian C-Spine Rule.

2. Do not order CT imaging to diagnose pulmonary embolism without first risk stratifying by determining pretest probability and m…