Shared Decision Making Is an Effective Model for Patient-Centric Care

Healthcare is in the midst of a shift toward more patient-centric and accountable care; as a result, time- and resource-constrained providers are embracing new and innovative models for delivering and organizing care. On Wednesday morning at AHIP’s Fall Forum 2012, Peter Goldbach, MD, chief medical officer, Health Dialog Services Corporation, spoke about the practice of shared decision making (SDM), a model which provides patients with informative tools to help them decide on treatment options.

SDM is a model by which doctors provide their patients with aids that offer information and options for treatment. According to Dr Goldman, there currently exists a gap between what patients want and what is actually happening. When considering that 33% of medical decisions have more than one treatment option, it makes sense for patients to be provided all possible options so that they might be able to select a treatment that they prefer for one reason or another. Studies have shown that many people would opt not to have surgery if they knew alternative treatment options existed.

SDM is a collaborative process where the provider presents information to the patient through a tool called a Shared Decision Aid. These aids help the patient fully understand their condition, as well as all treatment options, benefits of treatments, and side effects. Dr Goldman explained the following tools contained in a Shared Decision Aid:

• Evidence-based health information
• Short videos of patients describing their decisions and the outcomes they can get
• Short videos of prominent physicians and researchers explaining key insights
• Animations showing anatomy, disease process, and study findings
• Designs that accommodate different learning styles

Shared Decision Aids are usually provided in the form of DVDs, brochures, and web-based offerings. When it comes to population-based SDM, Dr Goldman stated that it is necessary to “find the right people, capture their attention, and empower their choices.” He also offered some data showing the potential of the SDM model; a study presented to the New England Journal of Medicine in September 2010 showed that the SDM model had cut total costs by 3.6% and had reduced population admissions by 10.1%. Additionally, it resulted in a net savings of $6.00 per member per month.

A potential problem for some providers is transitioning to this model in a way where they are still able to accomplish their normal daily routine. The SDM model by nature requires more time to be spent with patients in order to make sure they understand all of their options. However, with a strong emphasis on quality improvements due to healthcare reform, this model stands to yield long-term benefits for both the patient and provider.