Shared decision-making and value-based care are emerging approaches to obtaining additional value from patient care. Shared decision-making is the process of interacting with patients who wish to be involved in arriving at an informed, values-based choice among two or more medically reasonable alternatives. It attempts to stimulate collaborative discussion between physicians and patients to better align the pursued outcomes with the patient’s needs. Values-based care is care that is sensitive to the individual preferences and values of the patient. It is based on the idea that, to maximize effectiveness and efficiency, funds ought to be allocated so that they create the most value for the patient.
A significant medical diagnosis is a terrifying experience. Treatment choices are complex, with profound implications on finances and quality of life. There are often several different treatment options depending on the age of the patient, overall health. Often, alternative treatment options are available, as well. Every option has trade-offs such as survival, side effects, and cost. As a result, no treatment recommendation is right for every patient, making recommendations difficult for physicians. Patients are left to make the difficult personal and emotional choices about survival, treatment choices, quality of life, and cost.
Every person with cancer is unique, yet our system is largely based on “one size fits all” treatment protocols.
New Approaches to Making Intensely Personal Decisions
Some medical decisions are uncomplicated because there is one best treatment; a broken leg for example. For diagnoses like cancer, in which there is not one clear course of treatment, shared decision-making can ensure the treatment choice best aligns with patients’ preferences and values.
Shared decision-making provides numerous benefits for patients, clinicians, and the healthcare system at large. These benefits include more educated patients, less anxiety over the care process, improved health outcomes, reduction in unnecessary treatment and treatment costs, and a more personalized care experience.
Healthcare decisions are deeply personal choices. As such, patients want their values and preferences to weigh heavily into their treatment.
Shared Decision-Making and its Purpose in Healthcare
Shared decision-making is the process of interacting with patients who wish to be involved in their treatment choices. Shared decisions are informed, values-based choices, made by a patient and their physician, between two or more medically reasonable alternatives. Shared decision-making creates an intersection between the clinicians’ expertise and the patients’ intuitions about their circumstances and goals of care.
SDM is not intended to tell Healthcare Providers How They Should be Practicing Medicine
Because SDM is only information, it cannot provide guidance by itself. It is meant to complement, not replace, clinical judgment that is tailored to individual patients. Shared decision-making is not a clinical practice guideline, it does not replace clinical practice guidelines, and it does not make clinical practice recommendations.
Evidence for Benefits of SDM and Decision Aids
Studies also illustrate the potential for wider adoption of shared decision-making to reduce costs. Consistently as many as 20% of patients who participate in shared decision-making choose less invasive surgical options and more conservative treatment compared to patients who do not use decision aids.
In studies performed between 2000 and 2014, 71% of respondents said they preferred sharing decision making. 80% of patients say they want their healthcare provider to listen to them, but only 60% reported that they actually listened, with less than half claiming that their doctor asked them about their goals and concerns. Patients who participated in SDM are three to five times more satisfied with their clinicians.
MyCancerJourney is intended to be an aid in the decision-making process. Board-certified patient advocates assist patients in understanding their diagnosis and prognosis, while preparing them for shared-decision making conversations with their physicians. This collaborative approach leads to greater patient satisfaction and compliance. For more information on MyCancerJourney’s navigation and support services, that assist with SDM, contact MyCancerJourney at info@mycancerjourney.com or by phone at 737.307.0077.
