The Key to Patient Empowerment
Decision aids need champions.
Posted Feb 03, 2017
Patients deserve to play a role in their healthcare decisions. Often the right choice depends on a particular patient’s goals – the same illness might warrant aggressive treatment for one person and minimally invasive treatment for another, depending on how each person weighs the pros and cons of those treatments.
But far too often, patients do not even know that they have an important role to play in their healthcare choices. Instead, they think doctors know what’s best for them. Consequently, they don’t feel empowered to make medical decisions.
That is why many patient advocates are excited about incorporating decision aids into medical care. Decision aids, for those of you not yet in the know, are educational materials designed to inform patients of the pros and cons of their health care alternatives while helping patients understand the relevance of their preferences in making health care choices. (I wrote about the origin of decision aids in my New York Times meh-selling book, Critical Decisions.)
But how do we get decision aids in front of patients and time to inform their healthcare choices?
Up until now, many patient advocates have operated on the theory that “if you build it, they will come” – in other words, if people develop decision aids, patients will use them. Sadly, that theory is a bunch of hoo hah. Instead, if you want to get decision aids into patients’ hands, you need to find local champions who educate clinicians about what decision aids are available and why they are an important part of clinical care.
Take the experience of Mass General Hospital, a renowned institution in Boston. In the mid-2000s, the hospital made around 40 decision aids available to clinicians, for them to distribute to their patients. Adoptions of these decision aids were underwhelming, with less than a dozen clinicians accounting for the majority of the decision aids used. So several local champions decided to train clinicians about decision aids. The training involved one of those enthusiasts making presentations at normally scheduled clinical practice meetings. The hour long training included:
- Time to watch a decision aid video
- A brief summary of local decision aid use
- A chance to discuss opportunities and challenges
- A quick explanation of how to order decision aids through the EMR
After this training session, decision aid use more than doubled:
The moral of this story is clear. If you want clinicians in your organization to give decision aids to their patients, take the time to train clinicians how and why to use them.
*Previously Published in Forbes*