Primary Care Decision Making Model

• Spine Care

• Breast Cancer Care

• Primary Care

Massachusetts General Hospital

The John D. Stoeckle Center for Primary Care Innovation is incorporating Shared Decision-Making® programs in an effort to improve patient involvement in decision-making in primary care. Eligible patients may receive one of 18 decision support programs through an “E-prescription” function that is integrated into the electronic medical record. Following discussion with the physician, this prescription triggers a number of actions, including:

•	A one-page printed description of the program given to the patient by the physician
•	An e-mail message to the distribution center with patient’s information, title and format of the program, and the prescribing provider’s name
•	A prescription record logged into a database for research purposes
The research underway will:
•	Demonstrate the ability to introduce and disseminate decision support programs to patients within a pilot group of primary care physicians.
•	Identify and understand the barriers and problems faced by clinicians in making decision-support programs an integrated part of the clinical practice of primary care.
•	Provide insight into how the process of “e-prescribing” programs affects clinician workflow and time, e.g., overall office visit time, time spent with patient in the decision-making process.
•	Gather feedback from the patients about their experiences, perceptions and satisfaction with receiving decision support programs; the effect the program has on their decision preference; what they think about the available options; and how they feel about making a decision.

This project. which will expand over time to include all MGH primary care physicians, offers great potential to increase the understanding of decision support in primary care. Find out more here.