Podcast: Karen Sepucha, PhD talks with Catalyst for Payment Reform about Shared Decision Making

Shared decision making is “really focused on the physicians and the doctors and health care team bringing in what [they] know about the clinical evidence…having that doctors expertise [applied] to this patient sitting in front of them and also bringing out and really recognizing the expertise of the patient in terms of their lived experience,” said Karen Sepucha, PhD.

Cick here to listen in on the podcast.

The Patient Support Corps program at MGH supports our mission to ensure patients are informed, involved and receive appropriate & meaningful care.

To alleviate the emotional and physical burden for patients, in 2021, the Health Decision Sciences Center at Massachusetts General Hospital launched the Patient Support Corps program. Here, through this program, premed college students serve as interns who work with patients ahead of medical visits. These interns call and ask if the patients would like support, then work with them to prepare a list of questions to take to their doctor’s appointment.

Read more: https://giving.massgeneral.org/stories/better-preparation-better-decisions-better-care

 

Dr. Karen Sepucha and Dr. Antonia Chen were featured in the MGH News & Highlights email promoting routine use of patient decision aids to facilitate quality communication between patients and providers.

Patient decision aids, High blood pressure vs. hypertension YT video, Helping Ukraine crisis, Women Talk Money event – The Pulse – Mass General Brigham

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.

Dr. Karen Sepucha and researchers and UCLA find cash rewards and relaxed safety guidelines are motivating, depending on political affiliation

Karen Sepucha, Lynn Vavreck, the Marvin Hoffenberg Professor of American Politics and Public Policy at U.C.L.A., along with Arash Naeim, Neil Wenger and Annette Stanton at the David Geffen School of Medicine at U.C.L.A. found that two strong incentives to motivate the unvaccinated, dependent on their political party affiliation. In a randomized survey experiment, a cash reward would make them more likely to get a shot if they identified as a democrat and if they didn’t need to wear a mask or social-distance in public once vaccinated they would more likely get a shot if they identified as a Republican. This work was featured in The New York Times here.

A new SDM study, funded by PCORI

Press Release

Karen Sepucha, PhD and Leigh Simmons, MD Approved for $2.2 Million in Research Funding for Promoting Informed Decisions about Cancer Screening in Older Adults (PRIMED Study)

Funds awarded by the Patient-Centered Outcomes Research Institute

Drs. Sepucha and Simmons from the Health Decision Sciences Center (HDSC) at Massachusetts General Hospital have been approved for a $2.2 million funding award by the Patient-Centered Outcomes Research Institute (PCORI) to address an important gap in our understanding of how to support clinicians and older patients in making good decisions about whether to continue colorectal cancer (CRC) screening. The study, Promoting Informed Decisions about Cancer Screening in Older Adults (PRIMED Study), will advance our understanding of how to best communicate evidence of cancer screening benefits and harms to older adults and is well aligned with PCORI’s mission.

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National Quality Forum Playbook in Shared Decision Making

Earlier this month, NQF published the NQP Playbook™: Shared Decision Making in Healthcare, which was developed with input from Dr. Sepucha and other experts in the field. The playbook has guidance for institutions looking to implement shared decision making and culminates important work by the NQF to recognize and promote SDM as a key tenet of improving healthcare quality. The playbook can be purchased here.