Shared Decision Making: We're in This Together

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This is Dr. Michael Barry's presentation given at the Feb. 14, 2011 Alliance for Health Reform Briefing.

This is Dr. Michael Barry's presentation given at the Feb. 14, 2011 Alliance for Health Reform Briefing.

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  • 1. Shared Decision MakingWe’re in This Together
    Michael J. Barry, MDPresident
  • 2. We Believe Patients Should Be
  • 3. Why Shared Decision Making in Health Care?
  • 4. Evidence of the Problem
    The DECISIONS StudyA Portrait of How Americans Make Common Medical Decisions
    Medical Practice Variation
    40 Years of Research Documenting Inconsistent Care
  • 5. Patients:
    Making Decisions in the
    Face of Avoidable Ignorance
    Poorly “Diagnosing” Patients’ Preferences
    Poor Decision Quality
  • 6. Shared Decision Making
    • Clinician and patient work together
    • 7. They share information
    • 8. About options and outcomes
    • 9. About preferences
    • 10. They work toward a consensus about the preferred test or treatment
    • 11. They reach an agreement on the test or treatment to implement
    (Charles C, Soc Sci Med 1997; 44:681)
  • 12. Supporting the Concept
    • SDM supported by patient decision aids improves decision quality
    • 13. Both patients and physicians support SDM
    • 14. Implementation models are demonstrating that SDM can work “in the trenches”
    O’Connor et al.
    Cochrane Database of
    Systematic Reviews, 2009
  • 15.
  • 16. Shared Decision MakingTRENDS
  • 17. Patient Protection and Affordable Care Act
    HR3590 Section 936
    Program to Facilitate Shared Decision Making
    To facilitate collaborative process between patients and providers .. and to incorporate patient preferences and values into medical plan
    Authorized not Appropriated
  • 18. Key Aspects of PPACA Section 936
    Produce patient decision aids
    Set quality standards and certify decision aids
    Create Shared Decision Making Resource Centers
    Grant funds to providers for development, use and assessment of SDM techniques using certified decision aids
  • 19. Section 3021 CMS Innovation Center Test innovative payment models to reduce expenditures and to enhance quality of care
    Option #9
    Assisting applicable individuals in making informed health care choices by paying providers for using patient decision support tools that improve individual understanding of medical options
    Section 931 Quality Measures Development
    Assessment of experience, use and quality of information provided to patients to inform decision making including the use of SDM tools
  • 20. Shared Decision Making is at the Core of Ethical, Patient Centered Care
    • Patient Centered Medical Home
    • 21. Accountable Care Organizations
    • 22. Meaningful Use of Health Information Technology (HIT)
  • Thank You!