The Foundation funds a unique multi-center project called the Primary Care Initiative. Each member of the Initiative has a project to integrate Shared Decision Making in primary care practice.
Massachusetts General Hospital
Massachusetts General Hospital is piloting a program to incorporate shared decision-making into adult primary care visits. During primary care visits, the physician can prescribe the shared decision making program through the electronic medical record and then the video is either mailed to the patient or available for them to pick up. The electronic prescription system gives a one page summary of the program and allows the physician to click a link to send the program to the patient. Programs available through this study are:
University of North Carolina
The primary care program at the University of North Carolina aims to test the feasibility, effectiveness, and efficiency of a mass dissemination of the CRC screening decision aid within a single internal medicine practice with a goal of screening 75% of eligible patients. The decision aids will be mailed to eligible patients to encourage them to be screened for colon cancer.
University of California Los Angeles
The program at UCLA plans to study the use of decision aids in small community based practices that serve low income populations to determine the barriers and solutions to integration of decision aids across the health care field. In addition to qualitative data collected, physician focus groups and patient interviews are planned to help resolve problems with implementing shared decision-making.
Dartmouth Hitchcock Medical Center
Primary Care research at Dartmouth Hitchcock Medical Center aims to assess the feasibility of integrating decision aids into general internal medicine practice while re-engineering the primary care visit and measuring decision quality. In previous phases of this study, patients received the Foundation’s program on PSA testing after a primary care visit; however in new phases of the study patients will receive the program before visiting their physician. This study aims to implement the program and 2 sites at DHMC and at the White River Junction VA to determine the feasibility of patients viewing the program before the primary care visit and to compare the outcomes for patients receiving the program before and after the visit. This study will also expand to include the CRC and some of the chronic condition programs
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University of California San Diego
The Primary Care Initiative project at the University of California San Diego focuses on the logistics of implementing shared decision making and creating buy in for the process at three different clinics. This project involves several components including determining factors that will predict a patient’s response to shared decision making as well as determining ways to use technologies such as electronic medical records and the internet to increase shared decision making.
