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Making Shared Decision Making Standard Practice in Health Care
Harlan M. Krumholz @hmkyale @PCORI #PCORI2017
Making Shared Decision Making Standard Practice in Health Care - - PowerPoint PPT Presentation
Making Shared Decision Making Standard Practice in Health Care - - PowerPoint PPT Presentation
Making Shared Decision Making Standard Practice in Health Care Harlan M. Krumholz @hmkyale @PCORI #PCORI2017 Shared Decision Making What exactly is shared about it? Assertion Health care professionals seek the best for their
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Assertion
Health care professionals seek the best for their patients.
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Assumptions
People expect to be told what to do.
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Assumptions
People expect to be shielded from information.
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Assumptions
People expect to defer to authority.
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What Needs to Change
Culture Structure Incentives
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What Needs to Change
Assumptions
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Your Data
Data Access
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Access to your own data…
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Because…
It’s yours It’s yours It’s yours It’s about you It’s about you It’s about you Stakes are high Stakes are high Stakes are high It’s yours It’s yours It’s yours It’s about you It’s about you It’s about you Stakes are high Stakes are high Stakes are high It’s yours It’s yours It’s yours It’s about you It’s about you It’s about you Stakes are high Stakes are high Stakes are high It’s yours It’s yours It’s yours It’s about you It’s about you It’s about you Stakes are high Stakes are high Stakes are high
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Because…
Transparency Accountability Accuracy Usability Power
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Patient Rights
Accessing and obtaining copies of one’s health information for one’s own purpose is a right, not a privilege, which is fundamental to your ability to participate in
- ur health care system.
https://www.healthit.gov/sites/default/files/2016_report_to_congress_on_healthit_progress.pdf
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The right extends to a broad array of information (e.g. lab results, images, prescriptions, notes), as well as to data holders (i.e. doctors, hospitals, health plans and providers)
https://www.healthit.gov/sites/default/files 2016_report_to_congress_on_healthit_progress.pdf
Patient Rights
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Per-page charges do not apply when the individual is requesting a copy of information maintained electronically.
https://www.healthit.gov/sites/default/files/2016_report_to_congress_on_healthit_progress.pdf
Patient Rights
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New Assumption
People have a right to their data.
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Your Choices
Permission and Knowledge
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https://andrei-lupu.com/team-work/the-art-of-assumption-making/
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Permission
Do I have permission to choose?
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Knowledge
Do I have knowledge I need?
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New Assumption
People have a right to decide and to the relevant information.
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What Else Needs to Change
Information
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Information Absence It is what is missing that is the problem.
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Problem Scientific enterprise cannot keep pace with the information needs of people and patients.
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Power to Generate Data Together Knowledge is generated in everyday
- practice. Each person is better for the
contributions of the person ahead of them– and helping the people who follow. And the studies more relevant, efficient, and impactful for their participatory nature.
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New Assumption
People have a right to participate actively in research– and research will be faster, better, and cheaper because of it.
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Need for Action We are not waiting…
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And… You are not alone. You are not unreasonable. You are not too annoying, bothersome, irritating…
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And… You are bringing much-needed change.
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Key
Collective action
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Collective Action
Access to data Control over decisions Participation in research
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What Needs to Change
Culture Structure Incentives
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