Massachusetts General Hospital (MGH) is the third oldest general hospital in the United States and the oldest and largest hospital in New England. MGH oversees 15 adult primary care practices, including community health centers in Boston and the surrounding communities that collectively provide care for over 200,000 patients. MGH became a Foundation-funded demonstration site in 2005 in order to better serve the hundreds of thousands of patients they see each year.
Leigh Simmons, MD discusses one reason patient decision aids are so effective.
Current Shared Decision Making Activities
The Massachusetts General Hospital (MGH) primary care implementation program is based at the Stoeckle Center for Primary Care Innovation and the Health Decision Sciences Center within the department of general internal medicine. Providers affiliated with these two centers have access to the entire suite of Informed Medical Decisions Foundation decision aids (Shared Decision-Making® programs).
An Innovative Model for Shared Decision Making
In the early years, MGH invested in the development of a necessary support system to allow primary care providers to prescribe a decision aid through the electronic medical record (EMR). A standard process of decision aid distribution was developed and includes the following steps:
- The provider determines that a patient is eligible for a decision aid. If determined during a visit, the provider discusses the program with the patient.
- The provider “prescribes” a decision aid through the electronic medical record.
- Staff from MGH’s Maxwell & Eleanor Blum Patient and Family Learning Center mails the decision aid to the patient, along with a return envelope and an evaluation questionnaire.
- A note is automatically generated in the EMR documenting that a decision aid was sent to the patient.
The MGH team is currently working to increase health care provider and staff familiarity with the decision aids, clinical evidence and the prescription process through CME-accredited workshops. These workshops have also been conducted with internal medicine residents as part of their curricula. If you are interested in learning more about SDM at MGH, subscribe to their monthly eNewsletter “Shared Decision Making in Practice at MGH.”
Future Program Goals
In order to enhance the shared decision making (SDM) process at MGH, the team hopes to:
- Expand the program to specialty care practices
- Develop automated mailings and a provisional referral process
- Focus on patient programming