Making medical decisions is complicated and can be overwhelming at times. It’s important to make sure that health care providers, patients, and caregivers are involved in the decision-making process. Many hospitals around the country are implementing what’s called Shared Decision Making. This term describes the process of patients and physicians working together to make decisions about care, from diagnostic tests and x-rays to surgical procedures. Medical evidence and clinical guidelines are combined with the patient’s preference and values to help inform decision making for individual patients. This approach is a core component of patient-centered care.
At Mass General Brigham, our Shared Decision Making program aims to provide patients and clinicians access to evidence-based educational materials to help patients learn more about their healthcare options. This process encourages better conversations between patients and clinicians so that they are mutually involved in deciding the treatment plan and assures that medical decisions are aligned with the patient’s preference and care goals.
Shared Decision Making is personalized medicine through education and conversation. When patients are engaged in these conversations and well-informed about different treatment options, they are more likely to make health care choices that provide them with the best outcome for them. Because we are all different, there is no single “best” treatment option, but with Shared Decision Making, our goal is to find the best treatment option for each individual patient.
In our program, we focus on two key areas:
- Engaging patients through the use of education materials, called decision aids
- Encouraging good conversations between patient and provider by using tools and communication skills training
Engaging Patients with Education Materials (Decision Aids)
To help inform and engage patients about their test or treatment options, Mass General Brigham’s clinicians provide decision aid tools, which are educational materials available in different formats (web, video or printed booklets). They can be “e-prescribed” to patients through the patient portal, which is integrated with the electronic medical record, or mailed directly to patients at home. Mass General Brigham currently has over 40 different topics available including cancer screening, diabetes, mental health, men’s health, women’s health, and much more. The tools are available to patients in a variety of ways whether before, during or after a visit. Patients should ask their clinician about the opportunity to review a decision aid.
For certain conditions, these tools are provided to patients prior to their appointment with a specialist so they have time to review and think about their options. If, for example, a patient has osteoarthritis in their knee and they’re thinking about whether to take medication or have surgery, a decision aid will help them better understand the risks and benefits of all the options.
The tools are easy to understand and allow patients to review them at their own pace, from the comfort of their own home, and with family or other care givers. After reviewing, patients often feel more informed and confident to talk with their care team about what’s right for them.
Encouraging Good Conversations
In addition to providing patients with more resources, we’re training our doctors on conversational skills to improve their ability to talk through difficult decisions with patients. We also coach doctors on the most effective and understandable way to relay that information back to the patient. In addition to offering these tools to our established clinicians, Mass General Brigham has piloted trainings with interns and residents at the beginning of their medical careers. Our goal is to integrate this process as a curriculum so that Shared Decision Making is built into the very foundation of our clinical care.