scholarly journals OpenNotes and shared decision making: a growing practice in clinical transparency and how it can support patient-centered care

2018 ◽  
Vol 25 (9) ◽  
pp. 1153-1159 ◽  
Author(s):  
Alan J Fossa ◽  
Sigall K Bell ◽  
Catherine DesRoches
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Information Exchange ◽  
Medical Decision ◽  
Shared Decision ◽  
Patient Centered ◽  
Clinical Notes ◽  
Binomial Regression ◽  
Centered Care ◽  
Efficient Information

Abstract Objective Prior studies suggest inviting patients to read their visit notes (OpenNotes) has important benefits for patient engagement. We utilized survey data to investigate our hypothesis that patients who read more notes would report greater shared decision making (SDM). Materials and Methods Our survey focused on the safety and quality implications of OpenNotes. 24 722 patients at an urban healthcare organization were invited to complete the survey, which included an item assessing the number of notes read and the CollaboRATE scale to measure SDM. We used log-binomial regression to estimate the relative probability of top CollaboRATE scores across number of notes read while controlling for several covariates. Results 6913 patients responded (28% response rate). Patients reading 4+ clinical notes in the past 12 months were 17% more likely to have top CollaboRATE scores when compared to patients who had not read a note in the previous 12 months (RR: 1.17, 95%CI: 1.04-1.32). Discussion There is a clear relationship between what SDM requires and the transparency OpenNotes provides. Access to clinicians’ notes can support the SDM model, which relies on efficient information exchange between clinicians and well-informed patients. Conclusion Our study showed evidence of a relationship between note reading and perceived SDM. Implementation of SDM is likely to expand, given its association with improved patient satisfaction, adherence, and medical decision making. Findings from this study highlight OpenNotes as a policy that institutions can implement as a facilitator of SDM and a manifestation of their commitment to patient autonomy and transparency.

The Role of Shared Decision-Making in Audiologic Rehabilitation

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Behavior Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Treatment Information ◽  
Centered Care ◽  
Potential Risks ◽  
Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

scholarly journals Shared Decision Making and Patient-Centered Care in Israel, Jordan, and the United States: Exploratory and Comparative Survey Study of Physician Perceptions (Preprint)

2020 ◽  
Author(s):  
Yaara Zisman-Ilani ◽  
Rana Obeidat ◽  
Lauren Fang ◽  
Sarah Hsieh ◽  
Zackary Berger
Keyword(s):  
United States ◽  
Decision Making ◽  
Shared Decision Making ◽  
The United States ◽  
Patient Centered Care ◽  
Survey Study ◽  
Shared Decision ◽  
Patient Centered ◽  
Centered Care ◽  
Comparative Survey

BACKGROUND Shared decision making (SDM) is a health communication model that evolved in Europe and North America and largely reflects the values and medical practices dominant in these areas. OBJECTIVE This study aims to understand the beliefs, perceptions, and practices related to SDM and patient-centered care (PCC) of physicians in Israel, Jordan, and the United States. METHODS A hypothesis-generating comparative survey study was administered to physicians from Israel, Jordan, and the United States. RESULTS A total of 36 surveys were collected via snowball sampling (Jordan: n=15; United States: n=12; Israel: n=9). SDM was perceived as a way to inform patients and allow them to participate in their care. Barriers to implementing SDM varied based on place of origin; physicians in the United States mentioned limited time, physicians in Jordan reported that a lack of patient education limits SDM practices, and physicians in Israel reported lack of communication training. Most US physicians defined PCC as a practice for prioritizing patient preferences, whereas both Jordanian and Israeli physicians defined PCC as a holistic approach to care and to prioritizing patient needs. Barriers to implementing PCC, as seen by US physicians, were mostly centered on limited appointment time and insurance coverage. In Jordan and Israel, staff shortage and a lack of resources in the system were seen as major barriers to PCC implementation. CONCLUSIONS The study adds to the limited, yet important, literature on SDM and PCC in areas of the world outside the United States, Canada, Australia, and Western Europe. The study suggests that perceptions of PCC might widely differ among these regions, whereas concepts of SDM might be shared. Future work should clarify these differences.

scholarly journals Partnerships to Improve Shared Decision Making for Patients with Hypertension: Health Equity Implications

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 97-102
Author(s):  
Aisha T. Langford ◽  
Stephen K. Williams ◽  
Melanie Applegate ◽  
Olugbenga Ogedegbe ◽  
Ronald S. Braithwaite
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Equity ◽  
Clinical Care ◽  
Lifestyle Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Broad Array ◽  
Centered Care

Shared decision making (SDM) has increas­ingly become appreciated as a method to enhance patient involvement in health care decisions, patient-provider communication, and patient-centered care. Compared with cancer, the literature on SDM for hyperten­sion is more limited. This is notable because hypertension is the leading risk factor for cardiovascular disease and both conditions disproportionately affect certain subgroups of patients. However, SDM holds prom­ise for improving health equity by better engaging patients in their health care. For example, many reasonable options exist for treating uncomplicated stage-1 hyperten­sion. These options include medication and/ or lifestyle changes such as healthy eating, physical activity, and weight management. Deciding on “the best” plan of action for hypertension management can be challeng­ing because patients have different goals and preferences for treatment. As hyper­tension management may be considered a preference-sensitive decision, adherence to treatment plans may be greater if those plans are concordant with patient prefer­ences. SDM can be implemented in a broad array of care contexts, from patient-provider dyads to interprofessional collaborations. In this article, we argue that SDM has the potential to advance health equity and improve clinical care. We also propose a process to evaluate whether SDM has occurred and suggest future directions for research.Ethn Dis. 2019;29(Suppl 1):97- 102; doi:10.18865/ed.29.S1.97.

scholarly journals Patient-Centered Care for Patients with Cardiometabolic Diseases: An Integrative Review

2021 ◽  
Vol 11 (12) ◽  
pp. 1289
Author(s):  
Maria do Céu Marques ◽  
Rute Pires ◽  
Miguel Perdigão ◽  
Luis Sousa ◽  
César Fonseca ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Patient Centered Care ◽  
Therapeutic Management ◽  
Care Planning ◽  
Shared Decision ◽  
Patient Centered ◽  
Quality Health Care ◽  
Cardiometabolic Diseases ◽  
Centered Care

Patient-centered care is essential in high-quality health care, as it leads to beneficial outcomes for patients. The objective of this review is to systematize indicators for the care of patients with cardiometabolic diseases based on patient-centered care, extending from the stages of diagnostic evaluation and care planning to intervention. An integrative literature review was conducted by searching seven scientific databases, and a narrative analysis was performed. A total of 15 articles were included, and indicators related to diagnosis and care planning/intervention were extracted. In the planning of care centered on the person with cardiometabolic diseases, the individuality, dynamics of the processes, flexibility and the participation of all stakeholders should be taken into account. The needs of the person must be addressed through the identification of problems; establishment of individual goals; shared decision making; information and education; systematic feedback; case management; meeting the patient’s preferences and satisfaction with care; engagement of the family; and therapeutic management. The indicators for intervention planning extracted were behavioral interventions, therapeutic management programs, lifestyle promotion, shared decision making, education patient and information, interventions with the use of technology, promotion of self-management, program using technology, therapeutic relationship, therapeutic adherence programs and specialized intervention.

scholarly journals Independent and Web-Based Advice for Infertile Patients Using Fertility Consult: Pilot Study (Preprint)

2019 ◽  
Author(s):  
Aleida Gerarda Huppelschoten ◽  
Jan Peter de Bruin ◽  
Jan AM Kremer
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Pilot Study ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Web Based ◽  
Online Platform ◽  
Centered Care

BACKGROUND Patient-centered care—that is, care tailored to personal wishes and needs of patients—has become increasingly important. It is especially relevant in health care areas where patients suffer from a high burden of disease, such as fertility care. At present, both diagnosis and treatment for infertile couples is provided at a single hospital. As a consequence, patients are not likely to receive optimal, independent advice regarding their fertility problems. Internet-based, independent advice could be feasible for large groups of patients because it is not limited by travel distance and overhead costs. OBJECTIVE The aim of this study was to explore the experiences of both patients and professionals with an online platform using video consultations for patients with infertility seeking independent advice for their fertility problem. METHODS This pilot study evaluated an online platform, Fertility Consult, where patients with infertility can get independent advice by a gynecologist through a video consultation, thus eliminating the need of meeting the doctor physically. Semistructured interviews were performed with 2 gynecologists and the chairman of the Dutch patients association. This information was used for a patients’ questionnaire about their first experiences with Fertility Consult, including questions about the level of patient-centeredness and shared decision making, using the Patient-Centered Questionnaire-Infertility (PCQ-Infertility) and the CollaboRATE questionnaire, respectively. RESULTS Of the first 27 patients enrolled at Fertility Consult, 22 responded (82%). Most patients (82%) visited Fertility Consult for a second opinion, seeking more personal attention and independent advice. The mean level of patient-centeredness on the PCQ-Infertility questionnaire was 2.78 (SD 0.58) on a scale of 0 to 3. For the CollaboRATE questionnaire (scale 0-9), patients provided a median score of 8.0 (range 7-9) on all 3 questions about shared decision making. CONCLUSIONS Patients were satisfied with independent, well-prepared, Web-based advice; health care professionals felt they were able to provide patients with proper advice in a manner befitting patients’ needs, without any loss of quality. Future studies should focus more on the separation of advice and treatment and on Web-based consultations compared with face-to-face consultations to ascertain the possibility of increased patient involvement in the process to improve the level of patient-centered care.

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