~Written by Kasey Boehmer, Knowledge and Evaluation Research Unit
This report is based on information, recommendations, and conclusions arrived at through the organization’s convening of state and federal officials, SDM experts, and consumer, purchaser and provider representatives in October of 2011. It highlights what progress has been made at the state policy level to include SDM in healthcare delivery system improvement initiatives, state legislation, and public-private partnerships.
At the state policy level in many examples, legislators have focused on using SDM as a means to cut cost and reduce variation among conditions that demonstrate high variation across healthcare practices throughout the nation. Policy makers are keen on developing measures that accurately pinpoint SDM’s impact on cost and variation.
However, physician resistance was a key barrier to SDM implementation at the state level discussed during the October 2011 meeting. The report notes that physicians were less amenable to using SDM when the focus was placed on reduction of costs and variation. Instead clinicians were more welcoming to SDM when it was shown to improve patient care and better inform patients, and they were more interested in the length of visits that included SDM and how it would fit into clinical workflows.
The Knowledge and Evaluation Research (KER) Unit’s research to test decision aids within the clinical encounter has focused on assessing how our SDM tools impact patient satisfaction and knowledge, clinician engagement, the length added to clinical visits, and where SDM is most effective within clinical workflows. These tenets remain of key importance to clinicians, whose buy-in is critical to implement high quality SDM that will truly benefit patients. We should not lose sight of this in the policy-making arena where the focus begins with patient-centeredness but can too easily be shifted to cost savings and reduction of variation.