A Care Experience with Shared Decision Making
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Presentation given at the Foundation's Jan. 26 Research and Policy Forum by Richard Wexler, MD, director of Patient Support Strategies for the Foundation.
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A Care Experience with Shared Decision Making
- 1. Richard Wexler, MD Director, Patient Support Strategies Shared Decision Making in Primary Care Moving From Concept to Reality
- 5. Overview – The “Sites” Funded Demonstration Sites Primary Care Specialty Care Massachusetts General Hospital X University of North Carolina X Maine Health X Mercy Clinics Inc. X Stillwater Medical Group X Oregon Rural Practice Based Research Network X Palo Alto Medical Research Foundation X Group Health Cooperative X X University of Washington X X Allegheny General Hospital - Breast Center X University of California San Francisco - Breast Center X Dartmouth Hitchcock Medical Center (DHMC) - Breast Center X DHMC - Urology X DHMC - Orthopedics X DHMC - Spine Center X DHMC - Cardiology X
- 13. Patient Responses After Viewing DA: Overall how would you rate the program? Data submitted to Illume data warehouse as of 4-January-2011 n=1571 n=458
- 14. Patient Responses After Viewing DA: How important for clinicians to give DAs to patients? Data submitted to Illume data warehouse as of 4-January-2011 n=780 n=264
- 15. Patient Responses After Receiving DA: How much of the video did you watch? Data submitted to Illume data warehouse as of 4-January-2011 n=1582 n=472
- 16. Percentage of Correctly Answered Knowledge Questions By Amount of Video Watched Data submitted to Illume data warehouse as of 4-January-2011 n=546 n=144 NOTE: Does not include patients who read ALL of booklet * Scores for patients who watched NONE or ALL of the video are statistically significantly different at the p<.05 level
- 17. Patient Responses Before & After Viewing DA: How far along are you with this decision? Before DA After DA Preference-Sensitive Before DA After DA Screening Decided/ Close to deciding Not thought about it/ Considering options Data submitted to Illume data warehouse as of 4-January-2011 * NOTE: All before/after comparisons are statistically significantly different at the p<.05 level
- 18. Patient Responses Before & After Viewing DA: What are you leaning toward doing? Before DA After DA Before DA After DA Before DA After DA CRC Screening Surgery PSA Screening Data submitted to Illume data warehouse as of 4-January-2011 n=914 n=162 n=332
- 19. Thank You
Notas do Editor
- But it’s worth pausing for a moment to consider what we mean by “proof”
- Add ACOs
- To start with, we hoped to find organizations that had a high likelihood of succeeding We also wanted to establish a shared schematic or conceptual framework for the implementation efforts
- Not meant to be strictly linear Two items I will present with a little more detail
- We are also working on distribution rates rather than distribution numbers as well as viewing rates So, onto our approach to implementation strategy ….
- Today I’d like to provide : If all goes according to plan – we should have 10 or 15 minutes for Q and A
- Other significant differences: Screening ------------------------------------ None Most (58% 84%) Some All (70% 87%) Most All (84% 87%) Preference-Sensitive ------------------------------------ None Most (35% 57%) Some All (49% 62%)