Shared Decision Making in
Practice at Partners 
Health Decision Sciences Center

June, 2018
Issue 24
In this issue

Welcome to the Shared Decision Making (SDM) program newsletter. In this newsletter you will find: updates to the available patient decision aids, project updates, and useful resources and links.
New decision aids available through Epic! 

Healthwise Shared Decision Points can be ordered for patients through Epic. We now have over 40 topics available in both English and Spanish! Here are some new topics:

  • Advance care planning: should I stop treatment that prolongs my life?
  • Aspirin: should I take daily aspirin to prevent a heart attack or stroke
  • Atrial fibrillation: should I take an anticoagulant to prevent stroke?
  • GERD: Which treatment should I use?
  • Obesity: should I take weight-loss medicine?
  • Quitting smoking problems: should I use medicines?
  • Breast cancer screening: when should I start mammograms?
  • Lung cancer screening: should I have a CT test?
  • Prostate cancer screening: should I have a PSA test?
  • Colorectal Cancer: which screening test should I have?

The tools support patients in understanding their choices, comparing risks and benefits, and consider their preferences to decide what's right for them .

View the new Healthwise shared decision points via  Partners Handbook or access the Healthwise online version.

Epic ordering instructions and a list of all available decision points can be found here.

Our team is happy to come to practices to present a tutorial on these new decision aids - let us know if you'd like us to present to your team. Thank you for your help engaging patients in shared decision making!
Physician experience with the new tools and features! 

Some highlights of the tools include: 
  • They are short, interactive decision aids
  • They are available in both English and Spanish
  • Patient responses to the online questions are fed back into their medical record and displayed in a PDF report for the clinician to utilize in a follow-up visit with the patient
Below are a few quotes from some primary care physicians who have used the tools and their features:
"The response summary somewhat helped me better understand my patient's treatment preferences and goals though it still wasn't clear what her choice would be, but did help me understand her values."  - MGH Primary Care Physician
"I was a big fan of sending out Decision Aids to my patients in On Call, but I never could close the loop - I never knew if the patient read the Decision Aid and how the information impacted their thought process/decision making. Now, I'm getting a brief message in my EPIC In Basket that quickly lets me know my patient has reviewed the Decision Aid, and even better, I can see their responses to a brief survey that lets me know their preferences, values, and knowledge about the topic, after they've reviewed the materials! All in all, it is just such a leap forward in the care I can give my patients."
- Dr. Mary McNaughton-Collins: MGH Primary Care Physician
International patient and family-centered care conference update 

On June 11-13, 2018, Mahima Mangla from the HDSC along with Debbie Kanady, a member of the HDSC patient advisory committee traveled to Baltimore to attend the International Patient and Family-Centered Care Conference (IPFCC). The goal of this conference is to find ways to make sure patients are meaningfully involved in all aspects of health care delivery and clinical research. Patients are required to be an author/presenter for every abstract. Their poster presentation titled "Engaging patient advisors to make clinical research studies more patient-centered: Lessons from five years with a patient advisory committee," detailed how the HDSC has systematically valued and incorporated the patients in the design and conduct of our research studies. It was an exciting venue to hear from patients about the value of shared decision making and brainstorm how to integrate across relevant healthcare domains. 
Launching a new CRICO funded project  

Malpractice suits are often driven by poor communication, mistrust and unexpected, unfavorable outcomes leading to regret. Michael Barry, MD and Karen Sepucha, PhD were awarded a 2-year grant from CRICO to examine whether patients who are prescribed a patient decision aid prior to one of four elective orthopedic operations have greater trust in the operating surgeon and lower decision regret six months postoperatively compared to patients not prescribed a decision aid. This project, titled,  Does perfected informed consent improve trust in the physician and reduce regret following orthopedic surgery , starts in July 2018. We hypothesize that by using decision aids to improve the informed consent process, we should be able to mitigate malpractice risk and improve the quality of care.