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Implementing Shared Decision Making at the Point of Care

As the healthcare industry places greater emphasis on value-based care, many providers are searching for ways to enhance the patient experience while reducing overall costs. In the past several years, many providers have implemented Shared Decision Making (SDM) processes that focus on delivering quality patient outcomes.

Today, many patients are ill-prepared to make informed health-based decisions on their own. While many health conditions– such as early-stage breast cancer, hip or knee osteoarthritis, and diabetes–  have more than one medically-acceptable treatment option, patients and providers must work together to determine the best path of treatment. With shared decision making, they can do just that, as it enables patient-provider collaboration to more effectively select the evidence-based medical care that best fits each patient’s values and preferences.

The Need for Shared Decision Making
According to the DECSIONS study, fewer than 50% of patients today can answer more than one question about their health conditions correctly. Furthermore, close to 33% of medical conditions have more than one treatment option, yet 20-66% of providers know little about their patients’ treatment preferences.

To eliminate the risk of often unnecessary procedures and associated expenses, it is crucial that patients – especially those with preference-sensitive or chronic conditions – and their providers establish an open dialog to discuss potential treatment options and possible outcomes. Furthermore, to help patients explore their preferences and make decisions that are consistent with their values, access to evidence-based, unbiased decision aids and trained health coaches have been proven to be effective.

Implementing Shared Decision Making
As the market shifts toward fee-for-value, shared decision making is becoming a major component of several government-mandated programs, including the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the U.S. Department of Health and Human Services (HHS). Providers need to implement shared decision making into their practices now more than ever.

Here are five steps to effectively onboard and manage a shared decision making program at the point of care:

  1. Build buy-in throughout an organization. To establish an effective shared decision making program, it must be an organizational priority. Senior leadership, management, and care teams must be willing to support and drive shared decision making practices forward to achieve successful results.
  2. Create an onboarding process. Educate the entire clinical team, making sure they understand the value of shared decision making. Make the integration process as simple as possible and provide financial incentives to further drive usage.
  3. Provide aids that produce outcomes. Offer engaging, high-quality decision aids that providers will endorse and patients will trust.
  4. Identify and engage patients. Promote shared decision making through patient materials, add drop-down menus in an EMR to serve as a reminder of available options when meeting with patients, and offer incentives to patients who view and engage with decision aids.
  5. Set realistic goals and measure the program. Determine desired results and track progress on key metrics including a decrease in costs, patient engagement, and reduction in preference-sensitive surgeries.

Proven Results
For more than 20 years, Health Dialog has provided shared decision making solutions to numerous health plans and providers. In that time, we’ve seen remarkable results, including a 13-16% reduction in medical costs associated with preference-sensitive conditions, 9.9% fewer preference-sensitive surgeries, and 95% patient participation.

If you are interested in learning more about our shared decision making offerings or to understand how to take the first step, watch our webinar, “5 Steps to Implement Shared Decision Making,” or download our white paper, “Implementing Shared Decision Making at the Point of Care.”

This post, originally published in 2017, has been updated.

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