Advancing Shared Decision Making
The Informed Medical Decisions Foundation, now a division of Healthwise, has been working to advance evidence-based shared decision making since 1989. We believe the only way to ensure that high quality health care decisions are being made is for a fully informed patient to participate in a shared decision making process with their clinician. Through our research and advocacy efforts, we are dedicated to helping people make better health decisions.
Last month, the Association of Health Care Journalists (AHCJ), with funding from the Patient-Centered Outcomes Research Institute (PCORI), offered the AHCJ Fellowship on Comparative Effectiveness Research. A group of 12 health care journalists from around the country spent four days in Washington DC at the PCORI offices getting a “crash course” in comparative effectiveness research (CER) and how it can be used to improve health and health care. The journalists represented a variety of news sources, including AARP, the Seattle Times, HealthLeaders Media, the Minneapolis Star Tribune, the Harvard Health Letter, KPBS News in San Diego, WHYY in Philadelphia, the Washington Business Journal, Modern Healthcare, Reuters Health, and the Virginian-Pilot.
Topics covered the gamut of CER and how that work could generate interesting and informative news articles.
- Comparative effectiveness research and patient-centered outcomes
- Patients front and center: How they’re changing research and care
- How to critique CER studies
- Resources for finding the best evidence
- Open science and data transparency
- The future of clinical trials
I joined Dr. Stephanie Chang, director of the Evidence-Based Practice Center Program at AHRQ, to present a session titled, “How Does This Information Get Used? What Do People Need the Information For?” Dr. Chang discussed how CER was used in evidence reviews that can be shaped into guidelines. I talked about using CER to inform and involve patients in their own health decisions. I tried to position shared decision making as an approach to define the “right” amount of health care for a population. With help from many people at Healthwise, I “drilled down” on our new Decision Point on lung cancer screening. The journalists were interested in both the content of the research as well as our processes for converting these data into plain language to help people make better health decisions. The journalists were attentive and, as you’d expect, asked great questions. Evaluations of the session by the journalists were very positive and included some constructive feedback that we can incorporate into future versions of the presentation. Representative comments included:
- “Dr. Barry’s talk was really helpful. Liked seeing the examples of Healthwise patient info.”
- “Pretty helpful, especially Dr. Barry. I got several specific story ideas that I will pursue.”
- “Glad we heard a tangible example of PDA. Dr. Barry was quite interesting, although I’d suggest he give more suggestions about ways we could report on shared decision making. AHRQ has been a very good source for me.”
The journalists were especially concerned about biased sources of information on health care technologies. I emphasized our nonprofit status and our stringent conflict-of-interest policies in my presentation.
Presenting at this fellowship program reminded me of the good work being done by Gary Schwitzer and his colleagues at HealthNewsReview.org. Gary, who worked at the Foundation in our early days, and his team review health news stories as well as health news releases. Ten of Healthwise’s medical editors currently participate as reviewers (David Arterburn, Steve Atlas, Mike Bierer, Karen Carlson, Kathleen Fairfield, Rich Hoffman, Jean Kutner, Mary McNaughton Collins, Mike Pignone, and Karen Sepucha). Using ten explicit criteria, stories are given a rating between zero and five starts based on how well they meet those criteria, and summaries are then posted on the website. HealthNewsReview.org has reviewed more than 2,000 stories since its inception in its quest to improve health news reporting. The Informed Medical Decisions Foundation supplied funding for this project for its first eight years, and now HealthNewsReview.org has core funding from the Arnold Foundation.
HealthNewsReview.org also maintains a list of “industry-independent experts” who have no financial ties to the drug and device industry, as a resource for journalists. You can also find a blog, podcast, and toolkits for helping people understand and interpret studies on the website.
Consumers get a great deal of their health information from the media. Accurate and unbiased health news reporting is critical to avoid misleading the public. Efforts like the AHCJ Fellowship Program on Comparative Effectiveness Research and HealthNewsReview.org are vital to this worthy end.
The third and final population we need to look at when we design patient engagement strategies is the caregiver. Surprised? Yes, they are the wild card in patient engagement. Continue reading
Managing the financial mix of patient populations in hospitals or clinics is a bit of science and a bit of an art. Today’s insured may be tomorrow’s at-risk or value-based-payment patient or member. The changes in reimbursement highlight the need for providers to retain patients or members for longer-term relationships versus the episodic care model of the past. These relationships will help promote efficiency in operations as well as financial and quality outcomes. Providers who build strong relationships, customer loyalty, and care coordination will be able to retain patients regardless of the fluid status of each individual’s financial relationship. Financial stability will come from providing appropriate levels of care to each individual. Continue reading
October 18‒24, 2015, is RightCare Action Week, a grassroots initiative of the Lown Institute, a nonprofit think tank, built on taking action to remind patients and health care professionals of “what good medical care can and should be.” Here at the Foundation and at our sister organization, Healthwise, we encouraged employees to think about what “right care” means to them and to participate in the “What RightCare Means to Me” photo campaign. Continue reading
I attended the 6th annual Wennberg International Collaborative (WIC) Fall Research Meeting in London September 2-4, 2015. This invitation-only meeting is a collaboration between The Dartmouth Institute (TDI) and the London School of Economics and Political Science (LSE). The WIC is a research network committed to improving health care by examining organizational and regional variation in health care resources, utilization, and outcomes. The goal of the collaboration is to better understand the causes and consequences of unwarranted variation—that is, variation in health care not explained by differences in population needs or preferences—around the world, leading to clinical improvement and policy change. Continue reading