How does “Shared Decision Making” differ from a regular medical appointment?
In the past, it was not unusual for a doctor to prescribe a treatment without understanding what it would mean for the patient. Shared Decision Making encourages higher quality conversations between doctors and patients to get a better sense of the patient’s goals, social support system, economic background and beliefs — before deciding on a path of care. Using decision support tools helps patients to better understand their choices, what happens during procedures, and the outcomes of a particular care path. A more robust decision process prior to clinical interventions means patients have a better overall health care experience.
When/how do patients receive decision aids?
Decision aids can be prescribed at various times in a patient’s care. For certain conditions, the tools are provided to patients prior to meeting with a surgeon. At Mass General Brigham, our clinicians can easily order these decision aids through the electronic medical record and send them directly to patients home or via the online patient portal for review. They are available as printed booklets, video or online website links.
When do physicians calculate PrOE scores?
Each practice works with PrOE in their own unique way; but generally, for practices piloting PrOE it is used at the time of consultation prior to a procedure. As part of the surgical or procedural decision making process, PrOE can either be done at the point of care with the patient there or it can be done in advance and the results can be shared with the patient.
If my PrOE score is “Poor,” will I not receive treatment?
Just because a rating is poor, it doesn’t mean a procedure won’t be considered. Sometimes we do procedures that may rate as inappropriate because they are so medically complex that they are outside the clinical guidelines. We have a review process in place with Medical Chiefs who make decisions on these types of cases.
How do I benefit from answering PROMs questionnaires before treatment?
PROMs questionnaires are useful for setting expectations and engaging patients and physicians in shared decision making. By looking at graphs like the ones on this website, patients can have a better understanding of what to expect when they undergo a particular procedure in terms of gain in function or reduction in symptoms. This can augment a patient’s discussion with their physician in the decision making progress.
Can PROMs inform physicians about possible treatment decisions?
PROMs allows for more efficient, more personalized care. By doing some of the data collection electronically before treatment, doctors can translate those symptoms into a validated score and trends that have clinical context. With this physical health information already collected, providers can spend more time talking to the patient about their goals and preferences and how to address their particular symptoms in the course of treatment.
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