A program at Massachusetts General Hospital is aiming to significantly increase the availability and quality of decision support information given to patients and their families.
The hospital has teamed with decision support vendor Healthwise to create the Informed Medical Decisions Program within the Massachusetts General Health Decisions Sciences Center, with Healthwise providing a $2 million, three-year grant.
The program will include research to prove the value of various tools to improve patient engagement, extend the science of measuring decision quality and assess ways to ensure patient get the information they need to make the best decision for themselves.
“As medical treatments get more complicated with interventions that are complicated, patients need more information on outcomes,” says Michael Barry, MD, medical director of the Stoeckle Center for Primary Care Innovation at Massachusetts General. Barry, a primary care physician for 30 years, recently returned to the hospital from employment at Healthwise to lead the new initiative.
A patient diagnosed with breast cancer has multiple choices of treatment to talk over with the physician, such as removing the breast via a mastectomy, having a lumpectomy around the area with cancer and then having radiation, or having a lumpectomy plus six to eight weeks of radiation while keeping part of the breast, which would take a couple of operations and still have a higher risk that the cancer would come back. That’s a lot to sort through, Barry says.
Consequently, the new program will lay out new processes for better helping patients make the decision right for them, supplemented with information technology.
The bottom line, according to Barry, is that doctors need to spend more time and attention helping patients walk through treatment decisions and not just make a diagnosis and set up a treatment plan. Clinicians want to do right for the patient, but without asking what the patient really wants, the patient doesn’t know if there is more than one reasonable treatment approach.
“I find myself too readily thinking patients will think like me,” Barry acknowledges. “We’ve learned that you’ve got to ask.”
To better inform patients, Mass Gen, working with Healthwise, will offer patients information packets with decision support aids merged with the patient’s electronic health record before they come in the office so they know what questions they want to ask. These types of aids also could include links to procedure-specific websites, or a booklet or DVD.
Patients coming in to the office for a follow-up visit and getting a new diagnosis also can get new decision support aids. This, Barry believes, is the future of patient decision support.
More information on the Informed Medical Decisions Program at Massachusetts General is available here. Barry also recommends a comprehensive decision support website for patients at Ottawa Health Research Institute in Canada, available here.
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