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Shared Decision Making: Policy Options for New Hampshire

Shared Decision Making: Policy Options for New Hampshire. Catie Burkhard Karen Doster Hope McIntyre. Outline. Overview of shared decision making Current research on shared decision making Challenges Profiles of shared decision making in practice Policy options.

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Shared Decision Making: Policy Options for New Hampshire

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  1. Shared Decision Making: Policy Options for New Hampshire CatieBurkhard Karen Doster Hope McIntyre

  2. Outline • Overview of shared decision making • Current research on shared decision making • Challenges • Profiles of shared decision making in practice • Policy options

  3. What is Shared Decision Making? “A collaboration between patients and providers to engage in open communication, which allows patients to choose care options that are based on the best available evidence and optimally suit their needs and preferences.”1 1. "What is Shared Decision Making?" Foundation for Informed Medical Decision Making. 22 May 2011. <http://www.informedmedicaldecisions.org/what_is.html>.

  4. Background Information • The Dartmouth Atlas research • Health utilization differences • Effective care, preference-sensitive care, supply-sensitive care • Example: PSA testing

  5. Decision Aids Forms: • Pamphlets, booklets • Decision guides • Online tutorials • Videos • Websites Information Contained: • Description of the illness/disease • Pros/cons of treatment options • Frequently asked questions • Thought-provoking questions about reader’s values and preferences

  6. Survey of Current Research • Increased patient knowledge • Decreased decisional conflict • Potential legal implications • Decreased medical care utilization

  7. Topics for further research • Evaluate long-term health outcomes • Quantify benefits of patient satisfaction • Standards for decision aids

  8. Challenges to Implementation

  9. Where is this happening now? • Washington State • Dartmouth-Hitchcock Medical Center • Philadelphia, PA

  10. Where is this happening now? • Washington State • SB 5930 passed in 2007 making SDM a high standard of informed consent • Washington State Health Care Authority demonstration project

  11. Where is this happening now? • Dartmouth-Hitchcock Medical Center • Center for Shared Decision Making formed in 1999 • Center for Informed Choices (CIC) within TDI • Breast cancer, spine disorders, prostate cancer

  12. Where is this happening now? • Philadelphia, PA • Patient Provider Decision Sharing Project • Integrates SDM in primary care clinics • Patients: high Medicaid population, low literacy, non-native English speakers

  13. Policy Options • No action at this time • Statement of support • Partnerships with DHHS • Creating incentives • Mandating use of shared decision making

  14. Policy Options • No action at this time

  15. Policy Options II. Statement of Support

  16. Policy Options III. Partnerships with DHHS • Hospitals and clinics • Insurance plans • Medical schools

  17. Policy Options IV. Changing incentives • Medical malpractice • Reimbursement structure

  18. Policy Options V. Mandating use of shared decision making • State-wide • Medicaid • State employee insurance

  19. Thank you

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