Shared Decision Making: Empowering Patients Through Education and Collaboration

A recent study showed that 45% of adults struggle with health literacy, the ability to understand health information and services. This can make it difficult for patients to make educated healthcare decisions. One of the strategies we can implement to shift these statistics in the right direction is shared decision making.

What is shared decision making?

According to the National Learning Consortium, shared decision making is a process in which clinicians and patients work together to make decisions on tests, treatments and care plans. Balancing clinical evidence that analyzes risks and expected outcomes with patient preferences and values, shared decision making is a critical component of patient-centered health care.

Why is shared decision making important?

Today, the healthcare industry is shifting from a fee-for-service system to a value-based system that reimburses clinicians, hospital systems and other members based on the quality of care and the patient experience. Implementing shared decision in clinical practice is one way to improve clinical outcomes and to ensure the patient takes on an active role in their healthcare. In many situations, there is no single "right" healthcare decision; choices about treatment, medical tests, and health issues come with pros and cons. Shared decision making is especially important when:

• there is more than one reasonable option, such as choosing between a screening or a treatment decision
• no one option has a clear advantage
• the possible benefits and risks of each option affect patients differently

Shared decision making allows the clinician to provide their patients with information that helps them make more informed care decisions that better meet their goals. It also encourages patient participation and improves patient/physician relationship. Outcomes have been shown to include:

• improved health outcomes
• enhanced quality of life
• delivery of more appropriate and cost-effective services

When patients are considered as members of their team, they tend to take an active part in their care. Shared decision making enables providers and patients to agree on a care plan that best meets the goals of the patient. Studies show that when patients make healthcare decisions, they tend to choose more cost-effective treatments. In addition, the better patients understand their care plan, the more likely they are to follow it. Both patient and provider satisfaction improves because care decisions are a collaborative effort.

How can technology help?

Health Information Technology tools are helping to make the shared decision a more streamlined process for clinicians and the patient. Interactive tools such as patient portals, personal health records, and secure electronic messaging can help with implementing shared decision making programs. For example, patients can access decision aids and relevant patient education materials via their patient portal

These tools allow patients to communicate with their doctor when they have questions or concerns via secure messaging. This facilitates more effective communication which can help the clinician identify problems early on before a major setback occurs and implement treatment to avoid readmissions or emergency department visits. 

Where to start as a provider?

Today, there are many resources providers can use to learn how to incorporate shared decision making into their practice. Here are a few that you can review.

• The agency for Healthcare Quality and Research developed a program called the SHARE Approach - Putting Shared Decision Making into Practice. Click here to learn more.
• The Patient-Centered Outcomes Research Institute has a program called Implementing Shared Decision Making: A New PCORI Intitiative, which includes research studies and continuing education programs. Click here to learn more.
• Dartmouth-Hitchcock is a leader in the area of Shared Decision Making. The health system developed the Center for Shared Decision Making in 1999 as the first center in the U.S. dedicated to encouraging doctors and patients to make decisions together. Click here to learn more.

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