MaineHealth is a nonprofit, integrated health system providing a range of care from prevention and health maintenance through tertiary services, rehabilitation, chronic care and long-term care. The health system serves three-quarters of the state’s population. MaineHealth became a Foundation-funded demonstration site in 2009 in order to better achieve its goal of achieving excellence in clinical care, patient safety, education and research.
Neil Korsen, MD talks about using the colon cancer screening decision aid at local practices.
Current Shared Decision Making Activities
MaineHealth currently has seven pilot sites, including two training sites for family medicine and internal medicine residents at Maine Medical Center, two rural hospital-owned family medicine and internal medicine practices, a rural community health center and two employee health practices. A hospital-owned primary practice will join the program in 2012. Providers at these pilot sites use Foundation decision aids (Shared Decision-Making® programs) on the following topics with their patients:
- Colorectal Cancer Screening
- Prostate Cancer Screening
- Chronic and Acute Low Back Pain
- Advance Directives
An Innovative Model for Shared Decision Making
To empower patients to make informed health care decisions, MaineHealth leaders launched Learning Resource Centers (LRCs) in 1998. These health education libraries are located in or near MaineHealth primary care practices and are staffed by health educators with expertise in behavior change, self-management support, health literacy, cultural competency and chronic disease. The LRCs provide educational programs, including Foundation decision aids (DAs), and credible health information to patients in a reliable and timely manner.
Two of the MaineHealth pilot sites have collaborated with onsite LRCs to allow for electronic referrals of DA-eligible patients to LRC health educators. The health educators are trained in the use of the Ottawa Personal Decision Guide and provide DAs for onsite or home viewing, as well as subsequent patient decision support. Shared decision making (SDM) encounters are then documented in the patient’s medical record.
Future Program Goals
In order to further develop the shared decision making program at MaineHealth, the team hopes to:
- Enhance capacity within practices for identifying DA-eligible patients and tracking SDM activities within the electronic patient record
- Create a Shared Decision Making Resource Center website to facilitate provider’s access to DAs and SDM implementation tools
- Enhance provider skills in recommending DAs and addressing DA content during follow-up visits
- Increase use of DAs for preference-sensitive conditions and studying outcomes of related SDM processes