SLIDE 1
NYSIA 2017
Stephen Norwood, MD
SLIDE 2 Publish Draft summary
- Recommended? First‐line? (decides Y/N
formulary status)
- Criteria (diagnosis, duration, dose,
contraindications)
Identify new drugs
- Review top 150 drugs used in workers’
compensation
Evidence review
- Literature search
- Review title/abstract
- Rank studies
Review
- Advisory board review
- Stakeholder input
Expanding the Formulary
Update NDCs monthly
SLIDE 3
- 11. Case Report and Description
- 10. Conference Proceeding/ Presentation Slides
- 9. Textbook
- 8. Other Treatment Guideline
- 7. State Treatment Guideline
- 6. Nationally Recognized Treatment
Guideline
- 5. Unstructured Review
- 4. Case Control Series
- 3. Cohort Study
- 2. RCT
- 1. Systematic Review/ Meta‐analysis
Must be indexed in PubMed
ating the study type (1‐11)
SLIDE 4
4
SLIDE 5
5
SLIDE 6
6
SLIDE 7
7
If treatment guidelines are like speed limits then…
7
SLIDE 8
8
Set them too low…
8
Guidelines that are too restrictive cause unnecessary delays, disputes, denials and friction, preventing workers from getting needed medical care, driving good doctors out of the system.
SLIDE 9
9
Set them too high…
9
Bad guidelines are worse than having no guidelines. If you set speed limits at 150-200 mph, there will be a lot of road kill.
SLIDE 10
10
Set them just right…
10
Guidelines should use UR judiciously, auto-approving care while limiting excessive/inappropriate utilization. Expertise in guideline development/delivery always comes with a track record.
SLIDE 11
What states use guidelines?
SLIDE 12
12
TDI Medical Denial Rates post-ODG
SLIDE 13 13
Conclusions
The decision to adopt guidelines were critical for Texans, as experience has now proven
– Evidence‐based medicine doesn’t vary from state to state – Strong record of success; dynamic process for update development, highly efficient interface – Support tools are numerous including free ODG Helpdesk, training and education
13
