A guide for engaging patients in the collaborative process of shared decision making.
8 Steps to Success
Implementing shared decision making (SDM) with decision aids.
When it comes to health care, where you live matters. In 1973, Jack Wennberg, an MD and an international leader in outcomes research, published the first of his research papers on wide variations in the distribution and usage of health care across the U.S. The variations in care were unwarranted because they couldn’t be explained by illness, the best available medical evidence, or, most importantly, patient preferences. Shared decision making (SDM)—a collaborative process that allows patients and their providers to make decisions together—was proposed as a solution to these variations, particularly for surgical procedures. And the rest, as they say, is history.
Jack, along with Al Mulley, an MD and an international leader in SDM theory and implementation, cofounded the Foundation for Informed Medical Decision Making in 1989—now the Informed Medical Decisions Foundation—and we’ve been working to advance shared decision making ever since.
We began our pioneering SDM work by developing unbiased, evidence-based decision aids to help patients make informed decisions that are aligned with their preferences. The decision aids were designed to help facilitate an SDM conversation and focused on the most preference-sensitive conditions.
For nearly a decade we funded research grants and fellowships to help broaden our knowledge of how medical decisions are made, how to increase patient involvement in the process, and what methods are most effective in presenting information. Everything we learned from these projects went right back into developing more high-quality decision aids.
In 2005, we began supporting research and implementation projects at primary and specialty care sites across the U.S. These “demonstration sites” provided vital insight on overcoming barriers to successful implementation of SDM, supported by decision aids, in real-world clinical settings. This knowledge became the building blocks for a six-step framework for engaging patients in an SDM conversation and an eight-phase model for successful SDM implementation across an organization.
To further advance shared decision making, we merged with Healthwise—the nonprofit with the world’s greatest reach in helping people make better health decisions—in April 2014. Our complementary strengths provide an even stronger voice for the patient. As one organization, we will help bring about a health care system that is truly responsive to the patient’s voice.
As the research and advocacy arm of Healthwise, we are focused on demonstrating the value of evidence-based information in helping people make better health decisions. We are also focused on promoting patient engagement and shared decision making through advocacy initiatives in the U.S. and beyond.