Advancing Shared Decision Making
The Informed Medical Decisions Foundation, now a division of Healthwise, has been working to advance evidence-based shared decision making since 1989. We believe the only way to ensure that high quality health care decisions are being made is for a fully informed patient to participate in a shared decision making process with their clinician. Through our research and advocacy efforts, we are dedicated to helping people make better health decisions.
290 Twitter participants…
3,806,868 Twitter impressions…
These numbers represent the impact of the recent Summer Institute for Informed Patient Choice (SIIPC) conference, held June 25-27 in Hanover, NH. Aligning with this year’s theme, “The legal and ethical implications of keeping patients in the dark,” conversations both in the conference room and “virtual” centered on informed patient choice, shared decision making, and health care reform. The passion for keeping patients informed could be seen, felt, and heard near and far.
Threading together various perspectives throughout the health care industry, including policy makers, lawyers, ethicists, clinicians, patients, and researchers, SIIPC provided a truly interdisciplinary approach to the issue at hand. Opening remarks by Jack Wennberg, Foundation co-founder and founder of the Dartmouth Atlas, and David Goldhill, author of “Catastrophic Care: How American Health Care Killed My Father— and How We Can Fix It,” set the stage for a lively 2½ days.
Jack brought to life the “geography is destiny” phenomenon, a circumstance rooted in variations of both practice of medicine and supply of resources. Informing patients, he argued, is a solution to both of these variations. What we need, said Jack, is to “kill informed consent and shift to informed patient choice.”
David spoke of his father’s unnecessary death from a hospital-acquired infection, which inspired him to investigate the health care industry and eventually led to his somewhat controversial, free-market perspective on how to fix it. David argues that health care has separated the role of the patient and customer, a phenomenon that happens in no other industry. Instead, the health care industry serves the payer as the customer, leading to a warped system where the interests of the payers are satisfied, instead of the patients. The solution David proposes is to treat the health care system like any other industry, where the patient is the customer and where information and transparency are the norm. His presentation and perspective were well-received yet controversial for SIIPC, prompting many conversations throughout the event.
The interdisciplinary perspectives at SIIPC weren’t limited to the presenters; the attendees came from various disciplines within health care and many had personal reasons for attending. This was most evident in the small group discussions throughout the conference, providing all attendees the opportunity to share their perspectives and build upon each other’s ideas. Each group explored the barriers to informing patients, how the various stakeholder groups represented can work together to solve this issue, and what next steps hold the most promise to achieving informed patient choice. These discussions produced pages of thoughts and ideas to move forward with, available to anyone interested by signing up for emails here.
The 2014 SIIPC not only explored the dangers and barriers of keeping patients in the dark, but also provided insights and solutions to the problem, applicable to all segments of the health care industry. From the 141 attendees, to the 3.8 million impressions, the call for informed patient choice has been heard. As health care reform moves forward, there is no doubt that the many ideas born here will make their way into the new, patient-centered system of care.
The Foundation will continue to maintain its identity as the research and policy arm of Healthwise, so we have been hard at work on our strategic plans for research and advocacy. Ben Moulton and Leslie Kelly Hall are leading the advocacy and policy efforts to transform the health care system into a truly patient-centered system. Advocacy efforts in the short run will focus on patient decision aid certification, promoting national and state policies supportive of informed and involved people facing health decisions, and penetration of shared decision making into new markets. Carrie Levin is heading the research efforts, with expert support from Jack Fowler and the rest of the research team. The evolving research strategic plan focuses on projects to improve decision-support and behavior-change solutions, projects to improve solution implementation, and projects demonstrating the value of these solutions in health care. As these projects unfold, we will be building a research infrastructure, developing clinical partnerships as collaborative “laboratories,” and further sharpening and standardizing key outcome measures. Continue reading
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