Clinical practice guidelines and shared decision-making aids
Blue Shield of California is committed to improving health with optimal outcomes. Clinical practice guidelines help by providing a summary of evidence-based recommendations for the evaluation and treatment of select common acute and chronic conditions.
Clinical practice guidelines focus on important aspects of care with recognized and measurable best practices for high-volume diagnoses.
The basis of the guidelines includes a variety of sources that are nationally recognized, or evidence-based, or are expert consensus documents. Additional points have been included where medical literature and expert opinion are noted.
Network physician involvement is a crucial part of the guideline development, as well as adoption for the organization after approval by Blue Shield committees.
Shared decision-making aids
Providers can also utilize certified decision-making tools based on their specialty. These tools assist physicians in discussing treatment options with their members (conservative to invasive) and include information on risk and potential outcomes. Patient decision-making tools aids are available on the topics of maternity and labor/delivery; total joint replacement and spine care; end of life care; and cancer screening.
Clinical practice guidelines
| Guideline | Consensus document |
|---|---|
| Asthma | Global Initiative for Asthma (GINA) |
| Behavioral Health | The American Psychiatric Association Psychiatry.org - Clinical Practice Guidelines The American Psychological Association APA clinical practice guideline development American Academy of Child and Adolescent Psychiatry (AACAP) |
| Cholesterol Management | American College of Cardiology/American Heart Association et al. |
| Chronic Coronary Disease | American College of Cardiology/American Heart Association et al. |
| Chronic Obstructive Pulmonary Disease (COPD) | Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2024 Pocket Guide to COPD Diagnosis, Management, and Prevention American Thoracic Society Pharmacologic Management of Chronic Obstructive Pulmonary Disease |
Diabetes |
American Diabetes Association |
| Heart Failure | American College of Cardiology/American Heart Association/Heart Failure Society of America 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure |
| Hypertension | American College of Cardiology/American Heart Association et al. |
| Kidney Disease | Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease |
| Opioid Use Disorder | American Society of Addiction Medicine (ASAM) The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder – 2020 Focused Update |
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