A quality mix: using evidence and experience to evaluate new technologies.
This article describes BlueCross BlueShield of Tennessee's (BCBST) success in blending evidence with experience. This process has provided a winning solution for members, providers, and the health plan. Provider input has proved to be an invaluable tool in assessing both new and established technologies. BCBST uses a variety of methods, from formal panels to a modified Delphi approach, to obtain provider input into the creation of clinical decision tools. Provider experience fills the gap in the assessment of technologies that are widely used but do not have sufficient evidence to support them. This approach has significant implications for health plan delivery. It also meets the Institute of Medicine's concern that every healthcare organization, purchaser, regulator and educational institution encourage the delivery of services based upon the best available scientific knowledge.
Mathis
Rick
R
Health Care Services, BlueCross BlueShield of Tennessee, Chattanooga, TN, USA. richard_mathis@bcbst.com
Doyle
Sharon
S
D054598:Blue Cross Blue Shield Insurance Plans / Q000458:organization & administration; D020000:Decision Support Systems, Clinical; D003697:Delphi Technique; D004496:Education, Continuing; D017598:Efficiency, Organizational; D004864:Equipment and Supplies; D019317:Evidence-Based Medicine; D006801:Humans; D011787:Quality of Health Care; D013673:Technology Assessment, Biomedical / Q000379:methods*; D013714:Tennessee; D014481:United States