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Clinical Practice Guidelines

Sharp Health Plan adopts clinical practice guidelines that are evidence-based and known to be effective in improving health outcomes. Effectiveness of guidelines is determined by:

•     scientific evidence, or
•     by professional standards, in the absence of scientific evidence, or
•     by expert opinion, in the absence of professional standards from recognized sources, or
•     involvement of board-certified practitioners from appropriate specialties in the development or adoption of clinical practice guidelines that are not from recognized sources.

Recognized sources used by the Plan include but are not limited to:

•    Professional medical associations:
     -  American Medical Association
     -  American College of Cardiology
     -  American Orthopedic Association
     -  American Academy of Pediatrics

•    Voluntary health organizations:
     -  American Diabetes Association
     -  American Heart/Stroke Association
     -  American Lung Association

•    National Institute of Health Centers and Institutes:
     -  National Heart Lung and Blood Institute
     -  National Cancer Institute

Sharp Health Plan has adopted the following clinical practice guidelines for practitioner use for diagnostic and treatment purposes:

1.    Treatment of High Blood Cholesterol in Adults: Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults: Adult Treatment Panel III (ATP III)
2.    Treatment of High Blood Pressure: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7)
3.    American Diabetes Association Standards of Medical Care in Diabetes — 2011

The Sharp Health Plan Quality Management Committee also approved for adoption the behavioral health guidelines Psychiatric Centers at San Diego has adopted for use by their clinicians:

1.    The American Psychiatric Association Guidelines
2.    The American Psychological Association Criteria for Treatment Guidelines
3.    The American Academy of Child and Adolescent Psychiatry Practice Parameters and Guidelines

If you have any questions about these clinical practice guidelines, please contact Provider Relations at (619) 228-2330 or provider.relations@sharp.com.