Identifying low-value care: the Royal Australasian College of Physicians’ EVOLVE initiative

Challenges and lessons arising from early adoption of a new approach towards determining what is good clinical practice

In March 2015, 41 medical specialties of the Royal Australasian College of Physicians (RACP) came together as part of the College’s EVOLVE initiative. The main aim of EVOLVE is to drive safer, higher-quality patient care through identifying and reducing low-value medical practices.1 In EVOLVE, “low-value” practices are defined as tests, procedures or interventions that are overused, inappropriate or of limited effectiveness (and, in extreme cases, potentially harmful). The name of the initiative reflects the dynamic and evolving nature of evidence-based medicine. EVOLVE is modelled on the Choosing Wisely initiative in the United States and similar initiatives underway in Canada, Italy and the United Kingdom.2