Health Dialog Connections

Higher satisfaction with care and treatment outcomes seen with shared decision making

A patient-doctor consultation improved by shared decision making

The shift toward patient-centered care and the popularity of high-deductible health plans are driving patients to take charge of their health and their treatment options. Shared decision making (SDM) is a process that engages and empowers patients to have more involvement in their treatment plans alongside their physician.

Partners Healthcare System has been using Health Dialog’s decision aids for patients considering hip and knee replacement.  Thomas Cha, MD, MBA, a Partners-based researcher, co-authored a study that was published in 2017 which found that, “Shared decision making did not just result in better patient experience ratings, but also improved patient outcomes.” The research showed that patients who were well-informed about their treatment options and who received their preferred treatment were more satisfied with their care and their symptom improvement—regardless of whether they had surgery or opted for non-surgical approaches. 

More than half of the patients in this study reported that they viewed “most or all” of the decision aid provided.  This high engagement rate suggests that patients are willing to invest the time and effort needed to understand their treatment options. An earlier research study [SMDM abstract 5M-6 2016 Mahima Mangia] indicated that, compared with briefer, less comprehensive decision aids, patients who viewed longer decision aids knew the correct answer to 80% of questions about common facts about the surgery they were considering. 

The Expansion of Shared Decision Making
In response to the increased use of shared decision making and research on its effectiveness, the Washington State Health Care Authority (HCA) started a program that certifies decision aids as meeting rigorous quality standards. The State’s certification criteria require thoroughly-documented details of the decision aid development process including evidence review, patient and clinician involvement, and plain language and risk communication principles. 

The Health Dialog decision aids used by the Partners researchers (mentioned above) were certified by the HCA as meeting these standards.

What’s Ahead for Decision Aids and Shared Decision Making?
Building on the efforts of HCA, three major organizations have released steps toward more widely implementing Shared Decision Making:

  • National Quality Forum (NQF) has published an Action Brief urging organizations that provide, receive, pay for, or make policies for healthcare to integrate Shared Decision Making into their practices and a Playbook filled with practical guidance for the design of SDM implementation strategies for health care organizations
  • The Centers for Medicare and Medicaid Services (CMS) requires that—as a condition for reimbursement—providers document shared decision making and the use of decision aids for some patients receiving implanted cardiac defibrillators or left atrial appendage closure devices, and for people undergoing screening for lung cancer with low-dose computed tomography
  • The National Committee for Quality Assurance (NQCA) includes certified or evidence-based decision aids as an element of provider support in the most recent population health management accreditation standards

With these notable organizations joining the movement, it is expected that the use of decision aids will continue to grow over the coming years, increasing not only patient engagement, but also satisfaction. 

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