Group Health physicians lead efforts to support shared decision-making
When patients are fully informed of their treatment options, they generally select the least invasive or costly one—and report greater satisfaction levels afterwards. So to help patients decide, Group Health now will provide patients with educational materials—called shared decision making tools—so they can make informed choices.
The project will use aids developed by the Foundation for Informed Medical Decision Making and Health Dialogue, including those on knee replacement, hip replacement, cardiac procedures, low back surgery, hysterectomy, breast cancer surgery (mastectomy vs. lumpectomy), and prostate surgery for benign and malignant conditions.
Videos are being distributed to patients in selected specialty clinics or mailed to their homes. They can also be viewed on MyGroupHealth.
"We're quite excited about this because this will help us help our patients," said Charles Jung, MD, orthopedist at the Capitol Hill Campus. He explains that when patients are better informed prior to their visit with a surgeon, they have a better idea of what's involved in a procedure, what they might expect before and after surgery. They ask more informed questions and make better use of the appointment time.
For example, patients with osteoarthritis of the hip or knee need to decide on treatment options, but joint replacement surgery may or may not be the right choice for them. The procedures can be risky and expensive. The educational DVDs guide patients through treatment choices, surgery options, risks, recovery time, and other things to expect.
The tools will be available for a number of procedures. Patients can watch the video as many times as they like, in the comfort of their own homes. At 40+ minutes in length, each video provides a lot of information--perhaps much more than they could get in a single office visit, and at much less cost, too.
According to Chris Cable, MD, Assistant Medical Director, Consultative Specialty Services and Acute Care, "Information presented in this manner has been shown convincingly in studies--including those performed here at Group Health--to improve patient understanding of their health care options, to reduce the rate of procedural interventions, and most importantly to increase patient satisfaction with their care provided and confidence in the decisions they make."
Shared Decision Making tools are part of the Content of Care initiative intended to minimize unintended variation within the group practice.
The Group Health Research Institute will evaluate the impact of the SDM tools as a result of a two-year grant from The Commonwealth Fund. The project, led by CHS Assistant Investigator David Arterburn, MD, MPH, will evaluate the impact of shared decision-making aids on a dozen common elective surgeries. Comparing two groups of patients, the research team will test the tools’ effects on the use of the surgical procedures, total health care utilization, and total costs.
Arterburn was recently quoted about his shared decision-making study in the Journal of the American Medical Association.