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"What [we need] is a radical change in the way medicine is practiced," says Angela Coulter, director of global initiatives at the Informed Medical Decisions Foundation and author of Engaging Patients in Healthcare, her latest book. Angela's book is a comprehensive, evidence-based textbook that explores the ways in which patient engagement can improve overall health care.
MaineHealth, a demonstration site of the Informed Medical Decisions Foundation, will be hosting a conference on May 17th, featuring national and local experts on shared decision making (SDM). Attendees will have the opportunity to attend a number of sessions on topics such as end of life care, risk communication, decision aids, patient engagement and preference-sensitive care.
Last week, MaineHealth, an Informed Medical Decisions Foundation demonstration site, held its first conference dedicated to shared decision making (SDM). The conference, entitled “Shared Decision Making: The Patient Voice in Health Care,” featured presentations from national and local experts on SDM, and focused on bringing the patient perspective into the health care delivery system.
Ishani Ganguli is a journalist and a second-year resident in internal medicine/primary care at Massachusetts General Hospital. As part of her residency, she practices at the Ambulatory Practice of the Future, an innovation lab for primary care. There, she is leading an effort to pilot a web-based point-of-care tool that engages various members of the health care team to help patients make better informed, personalized decisions about cancer screening and knee pain.
We are pleased to announce that March is Shared Decision Making (SDM) Month! During the month of March there will be a number of events highlighting the work of those advancing shared decision making as a means to provide high-quality, patient-centered care. These events will consist of a variety of formats (e.g. interviews, giveaways, publications, tweet chats and webinars) and will feature health care experts and advocates. We invite you to visit the SDM Month site often to stay up to date on events and other special features, as we will be adding them daily! We will also feature a number of guest bloggers. We hope you will join us in supporting the work of the shared decision making community by attending SDM Month events, either virtually or in person. You can follow the Twitter conversation at #SDMmonth.
The latest edition of Health Affairs focuses on a topic very near and dear to our hearts, patient engagement. Throughout the history of the Informed Medical Decisions Foundation, we have been dedicated to studying the components of patient engagement and how it affects the health care industry. Research shows that when patients are actively engaged in their care, they can experience better health outcomes, at lower costs. It gives me great pleasure to recognize the Foundation team members who are co-authors on publications in this edition of Health Affairs: New Era of Patient Engagement.
Posted in Current News, President's Corner
Tagged Benjamin Moulton, decision aids, Group Health, Health Affairs, Megan Bowen, patient engagement, practice variation, RAND Corporation, Richard Wexler, shared decision making implementation
Week three of Shared Decision Making (SDM) Month was quite educational as we explored shared decision making policy efforts in the U.S., as well as measures of decision quality. Our tweet chat on Tuesday examined a number of shared decision making policy issues from liability to informed consent to incentives for providers. On Tuesday night we gathered in Boston for a special screening of the new documentary, Escape Fire: The Fight to Rescue American Healthcare. Shannon Brownlee, who is featured in the film, stopped by to answer our burning questions about the current state of health care in the U.S. During Wednesday’s webinar, we heard from individuals involved with projects resulting from federal and state shared decision making legislation. Thursday’s webinar provided us with insight on developing and implementing decision quality measures.
The patient-physician relationship of yore was pretty much one-sided. Physicians used to tell their patients what tests and procedures needed to be done and didn’t really offer much information on their condition, nor were patients asked to be involved in decisions regarding their own care. That relationship has begun to dramatically change; patients want and are given more information, and they are more involved. There is a growing body of research that points out the benefits of patient engagement. There is more information flowing from physician to patient; patients are now seen as an excellent source of information when taking their history and their preferences are carefully considered – “nothing about me without me.”
Posted in Current News, SDM Month
Tagged "Choosing Wisely", ABIM Foundation, Daniel B. Wolfson, patient engagement, patient-centered care, patients, sdm, shared decision making, Shared Decision Making Month, unnecessary treatment
Jeff is a faculty member at the University of California, San Francisco (UCSF). He runs a patient support program at the medical center there, helping people weigh the risks and benefits of their treatment options. Jeff also advises other organizations implementing decision support programs around the United States and abroad. He has been hailed as a leading innovator by the Mayo Clinic and the U.S. Department of Health and Human Services.
Leana is an emergency physician at Brigham & Women's/Massachusetts General Hospital, clinical fellow at Harvard Medical School and a former Rhodes Scholar. Inspired by her own childhood illness and then her mother's long battle with cancer, Leana is passionate about guiding patients to advocate for better care. She has been featured in TIME, Newsweek, ABC News, NPR, CNN, MSNBC, Fox News, The New York Times, Washington Post, Women's Health and the award-winning HBO documentary Reporter.
Patricia is a thought leader and disruptive innovator in the field of behavioral health recovery. She is an activist in the disability rights movement and has lived her own journey of recovery after being diagnosed with schizophrenia as a teenager. Patricia is the creator of RECOVERYLibrary.com and the CommonGround web application to support person centered care and shared decision making in the psychiatric consultation.
Dave, better known as "e-Patient Dave," is a leading spokesperson for the e-Patient movement. A high tech executive and online community leader for many years, he was diagnosed in 2007 with Stage IV kidney cancer, with a median survival of just 24 weeks. He used the internet in every way possible to partner with his care team and beat this unbeatable disease. Today he is well. In 2008 he discovered the e-patient movement, and began studying, blogging and speaking at conferences, and in 2009 was elected founding co-chair of the new Society for Participatory Medicine.
Jessie is president and founder of the Center for Advancing Health, a nonpartisan, Washington-based policy institute which, since 1992, has been supported by foundations and individuals to work on people's engagement in their health care from the patient perspective. Jessie draws on her own experiences of treatment for four cancer diagnoses, interviews with patients and caregivers surveys and peer-reviewed research as the basis of her work to describe and advocate for policies and practices to overcome the challenges people face in finding good care and getting the most from it.
During each one hour tweet chat, a moderator and subject matter experts will lead a conversation about various aspects of shared decision making, including implementation in clinical practice, palliative care, integration into state and federal legislation, and patient engagement. All participants should include the hashtag #SDMchat in their tweets so the conversation can be archived.
Posted in Current News, SDM Month
Tagged decision aids, federal legislation, March 2013, palliative care, patient engagement, patient-centered care, quality care, shared decision making, shared decision making implementation, Shared Decision Making Month, state legislation, Storify, tweet chat
Angela, who is based in Oxford, England, coordinates the Informed Medical Decisions Foundation's international work. She is also a senior research scientist at the University of Oxford's Department of Public Health. Her previous roles include chief executive of Picker Institute Europe, executive director of policy and development at the King's Fund in London, and director of the Health Services Research Unit at the University of Oxford.
Posted in SDM Month
Tagged Angela Coulter, decision aids, March 2013, patient engagement, patient-centered care, quality care, shared decision making, shared decision making implementation, Shared Decision Making Month, The Kings Fund, UK
Week one of shared decision making (SDM) Month did not disappoint with great insight from providers, health systems, patients and others on the benefits and barriers to implementing shared decision making. We heard about innovative ways shared decision making is being implemented in the U.S. during Wednesday’s Shared Decision Making in the Real World webinar and got an international perspective during Tuesday’s first #SDMchat .
In June 2008, as part of my annual physical at age 61, my physician gave me a digital rectal exam. He felt a lump on my prostate that he felt needed further evaluation so he referred me to an urologist. The urologist performed a biopsy, which showed prostate cancer in two out of the twelve cores tested, with 10% cancer in each core and a Gleason score of 6. A Gleason 6 indicates a slow growing cancer. The urologist told me that I needed treatment and that since I was relatively young and healthy my choice could be surgery or radiation. His thinking was not whether I needed to be treated in the first place, but only what treatment would be best. He suggested I see a surgeon and radiologist to decide.
Steven is a physician and author of the prize-winning book, Doctor, Your Patient Will See You Now. He is the founder of The Shared Decision Center, writes a column for his town's weekly newspaper and appears regularly on its local NBC television affiliate. Follow Steven on Twitter: @med_advocate.
Steven will be joining the SDM Month tweet chat on patient engagement on Tuesday, March 26 at 2 p.m. ET. Join the conversation: #SDMchat.
Trisha is known as Every Patient’s Advocate. She is an author, About.com’s expert in patient empowerment, and a national speaker who teaches patients how to navigate the unwieldy and dysfunctional health care system and teaches providers how to communicate with their patients more effectively and efficiently.
Trisha is the founder and director of the Alliance of Professional Health Advocates, and AdvoConnection.com, a directory where patients and caregivers can find help from advocates who can facilitate their journey through the healthcare system, including private Shared Decision Making services. You can find her online at EveryPatientsAdvocate.com, Patients.About.com or Twitter: @TrishaTorrey.
Alicia works as a community manager at The HIT Community, a start-up company based in Wakefield, MA. She contributes to the User's View Blog providing her perspective on health information technology and social media issues facing patients and healthcare workers in today's rapidly changing healthcare industry. With an engineering background and MBA/MS degrees in information systems, Alicia applies her technical knowledge in creative ways to bring different healthcare communities together to leverage knowledge, solutions, and support in efficient, effective ways.
As part of the first-ever Shared Decision Making Month this past March, the Informed Medical Decisions Foundation interviewed Dr. Ishani Ganguli, a second-year resident at Massachusetts General Hospital’s own primary care innovation, the Ambulatory Practice of the Future (APF) and Short White Coat blogger. The APF focuses on empowering patients to be more engaged and involved in their health care by placing the patient at the very center of the care team. Ishani was drawn to APFs model of innovation and desire to understand the whole patient over a period of time. During our conversation with Ishani, we will hear how the APF is changing the future of primary care through technology, space and processes, and how shared decision making plays a role at the practice.
In recent years, efforts to implement shared decision making (SDM) in routine clinical practice have advanced; however, implementation has proved challenging and numerous reports have identified misaligned incentives in health care reimbursement as a root cause. On May 23 and 24, leading researchers, providers, policy makers and payers focused on facilitating widespread implementation of shared decision making will convene in Washington, D.C. to participate in a critical discussion about how to better align incentives to foster this spread.
Shared decision making to inform and involve patients in their health care decisions is gaining great momentum as a strategy to improve the quality and value of health care. However, making patient participation in decisions the rule, and not the exception, is challenging. Now is the time to convene patient advocates, providers, health care systems, policy makers and insurers to engage in a critical discussion about how to address this challenge and make it easier to do the right thing by informing and involving patients when it matters most -- when a decision is looming.
Transforming care so that shared decision making is standard practice must be a multi-stakeholder effort, with women, clinicians, hospital administrators, payers and policy makers doing their part. Childbearing women and their advocates have a critical role in demanding this kind of care. Women can “vote with their feet” by choosing providers who engage them in shared decision making and honor their right to informed choice. But they can also advocate for system changes so that shared decision making becomes the standard.