Decisions are something we all confront daily - from what to eat for breakfast to how to avoid a hazard in the road. Some are easy, some are hard. They have varying degrees of complexity and importance in our lives. Medical decisions can have a lasting and profound effect on our quality of life, but as a patient, we often defer decision making to our provider. When and how should patients be involved in decisions about their health?
Shared decision making offers patients more ownership in their medical outcomes by giving them more information about their health and treatment options. Decision-making aids are tools that providers can use to empower patients to educate themselves, consult family members, establish priorities and make a more informed decision together. Through the process of shared decision making, patients can better combine their own personal values and lifestyle choices with their healthcare provider's medical knowledge to determine an optimal personal care plan.
It is important to consider that some patients do not want to approach treatment this way. The information is overwhelming and confusing to different people in different circumstances. Lifestyle preferences that are important to the patient may prevent a positive outcome. Poor shared decision making can lead to poor patient outcomes. Are there ways to better inform and assist patients on their part of the decision?
Technology can play a useful role in shared decision making. Specifically, apps can be an effective means of offering information and choices gradually to a patient. Rather than accessing and processing all of the information at once, which can lead to feelings of overwhelm, an app can guide the patient through the information in a progression that matches the patient. An app can also collect information about goals and values from the patient, after taking time to process new information and reflect.
Shared decision making is a developing process with great potential to give patients more control over their health. Could this lead to more patient trust in the medical system? Could this lead to less decision-based malpractice lawsuits?
For more information, the following are great resources:
The International Patient Decision Aid Standards (IPDAS) was formed to create standards for decision aids to be used in a clinical setting.
The Ottawa Hospital Research Institute website includes searchable decision aids for patients, guidelines for creating decision aids, physician guidance for discussion and implementation of decisions.