This month, a much anticipated study was published in Health Affairs that addresses something we are often asked at the Informed Medical Decisions Foundation: What are the effects of decision aids on utilization rates and medical costs? Researchers from Group Health Cooperative found that when decisions aids were used for patients making a decision about whether or not to have elective knee or hip replacement surgeries, there was a significant drop in surgical procedures as more patients opted for more conservative, less costly treatment options.
Posted in Current News, President's Corner
Tagged cost, decision aids, Group Health, health care, hip osteoarthritis, hip replacement surgery, Jack Fowler, knee osteoarthritis, knee replacement surgery, Michael J. Barry, PBS, practice variation
We are pleased to announce the release of our newest report on shared decision making (SDM) research. For nearly a decade, the Informed Medical Decisions Foundation has funded research grants and fellowships to help broaden our knowledge of how medical decisions are made, and how to increase patient involvement in the process. “We’ve reached a juncture where we thought it was a good time to put together a document that displays some of the highlights of the research we have supported over the last few years,” says Floyd J. Fowler, Foundation senior scientific advisor. “There are things we know now that we didn’t know just a few years ago that are highlighted in this report, which we hope can help researchers and others promote shared decision making moving forward.”
For more than 20 years, the Dartmouth Atlas Project has documented significant variations in the distribution and usage of health care resources in the United States. A key resource in understanding our health care system, the project serves as a foundation for ongoing activities to improve our overall system.
Many doctors aspire to excellence in diagnosing disease. Far fewer, unfortunately, aspire to the same standards of excellence in diagnosing what patients want. In fact, we will present an accumulation of evidence which shows that preference misdiagnoses are commonplace. In part, this is because doctors are rarely made aware that they have made a preference misdiagnosis. It is the silent misdiagnosis.
A sleeper provision of the Affordable Care Act (ACA) encourages greater use of shared decision making in health care. For many health situations in which there's not one clearly superior course of treatment, shared decision making can ensure that medical care better aligns with patients' preferences and values. One way to implement this approach is by using patient decision aids -- written materials, videos, or interactive electronic presentations designed to inform patients and their families about care options; each option's outcomes, including benefits and possible side effects; the health care team's skills; and costs. Shared decision making has the potential to provide numerous benefits for patients, clinicians, and the health care system, including increased patient knowledge, less anxiety over the care process, improved health outcomes, reductions in unwarranted variation in care and costs, and great alignment of care with patients' values.
Posted in Cost, Decision Aid Effectiveness, Health Care Policy, Patient Decision Aids, Patient Preferences, SDM Implementation
Tagged ACA, CMS, Cochrane Collaborative, decision aids, Group Health, health care costs, HHS, IPDAS, Medicare, NEJM, PCORI, practice variation, shared decision making
The strongest argument for shared decision making is that patients have a fundamental right to understand all the reasonable medical options and the arguments for and against each option. Simply put, informing and involving patients in medical decisions is the right thing to do. By being informed and involved, patients have the ability to avoid having surgery that exposes them to risks they do not think are worth the benefits. In addition to those certain benefits, the evidence is also mounting that shared decision making is likely to pay for itself -- and it may well do better than that.
Kansas City Fox News affiliate discusses how shared decision making is helping to address unwarranted variations. In under five minutes, Fox4's Meryl Lin McKean takes us inside Mercy Clinics, an Informed Medical Decisions Foundation demonstration site, in Waukee, IA. Footage shows a patient watching a Foundation decision aid.