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Table 5 Root causes of and potential interventions to decrease practice pattern variabilities

From: Endocrinology practice patterns of hypothyroidism and osteoporosis management in a U.S. tertiary academic medical center

Root Causes Potential Interventions
Misinformation available to the public and patients • Increased development of evidence-based patient educational materials
Convenience of ordering a wide variety of diagnostic and monitoring tests • Implementation of electronic clinical decision support tools based on standards of care
Inefficient use of endocrinologists and/or clinical visit encounters • Training and greater use of mid-level providers with disease-specific tasks (i.e. skilled nurse practitioners to monitor DXA scans and/or laboratory results between clinical visits)
• Deployment of telemedicine to assist with laboratory follow-up not requiring a visit
Fee-for-service system, which favors frequent follow-up visits, radiology studies, and laboratory tests • Proper implementation of value-based care
• Development of low-value care metrics