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Tools for helping patients make informed decisions
Since Massachusetts General Hospital established one of the first shared decision-making programs in the country in 2005, it has been a leader in promoting the routine use of patient decision aids to facilitate quality communication between patients and providers.
Today, clinicians and patients across Mass General Brigham are increasingly relying on more than 150 available shared decision aids to improve the quality of their conversations about significant medical decisions.
“These step-by-step tools help patients to understand their choices, compare risks and benefits and express their preferences and personal values in order to decide what is right for them,” says Karen Sepucha, PhD, director of the Health Decision Sciences Center in the Division of General Internal Medicine at Massachusetts General Hospital and an associate professor in Medicine at Harvard Medical School. Most frequently, they are used by patients considering a surgical procedure, but there also are decision aids for patients considering options for management of chronic conditions, cancer screening tests or birth options after a cesarean section.
Research, conducted from over 105 randomized trials across 50 different conditions and involving 31,000 patients, supports the idea that decision aids help patients to better understand their options, both good and bad, says Dr. Sepucha. Studies have also found that these tools significantly improve knowledge and involvement of patients who may have access to fewer resources because of their race, ethnicity, language or socioeconomic status.
“What I like about using the shared decision aids is they provide an opportunity to discuss points a patient may not have brought up otherwise,” says Antonia Chen, MD, MBA, director of Research, Arthroplasty Services at Brigham and Women’s Hospital and an associate professor of Orthopaedic Surgery at Harvard Medical School. “A shared decision-making aid may enable patients to ask more questions, indicating that patients are better informed, and we are able to have deeper discussions.”
When a tool is completed online through the patient portal, a summary is added to the patient’s medical chart to be available for future conversations, and as a reference for the patient. These enhanced online shared decision aids are currently available in English and Spanish. Print format decision aids are available in English, Spanish, Portuguese, Haitian Creole, Russian, Traditional Chinese and Arabic.
Primary care and specialty care providers and their staff may order decision aids for a patient via Epic. Patients using Patient Gateway may access the decision aids there.
To help with the ordering process, the Health Decision Sciences Center has created a tip sheet and a demonstration video. To view the various decision aids available online, visit this link. If you have questions about the decision aids, email decisions@partners.org.