IOM: Introduce patients to medical evidence to enable informed decision making
They want it, so why aren't they getting it? Give patients access to medical evidence to facilitate informed decision making, says a Sept. 25 Institute of Medicine report based on the work of the roundtable on value and science-driven healthcare.
“A continuously learning health system can deliver truly patient-centered care only when patient preferences—informed by medical evidence and provider expertise—are elicited, integrated and honored,” the report read. “Shared decision making is the process of integrating patients with medical evidence to achieve high quality medical decisions.”
Current research suggests that providers are far more likely to discuss the potential benefits of health interventions than the potential risks and rarely ask for patient preferences, according to the report. This is despite indications that the majority of patients want providers to listen, tell the truth about diagnoses, discuss risks of treatment options and discuss how treatment options may affect quality of life. Correcting the situation will require patient access to the best available medical evidence, unbiased health counseling based on clinical experience and a willingness to elicit and honor patient preferences.
These conclusions were based on polls of patient focus groups and roundtable meetings, which also led to the development of specific phrases for providers to use that may be particularly effective. These include:
“Successful messages include framing messages in a positive way, embedding discussions of medical evidence in the context of a strong relationship with a trusted provider, using language that conveys to patients that the focus is on them and expressing that the goal is to provide patients with the best possible care,” the report read.
There are three key areas where action is required to improve patient-centered care enabled by patient-provider communication, according to the report. Healthcare culture must be redesigned to encourage the practice of informed medical decision making among providers, various stakeholders’ incentives must be aligned to facilitate informed medical decisions and appropriate quality measures should be enacted to hold providers accountable to a standard that requires patients have access to medical evidence.
“By focusing on these target areas in patient engagement, clinician stewardship, institution and policy facilitation, and research promotion, those dedicated to improving evidence communication can realize a profound and immediate opportunity to improve the health of Americans,” the report concluded.
The report is available in its entirety from the IOM.
“A continuously learning health system can deliver truly patient-centered care only when patient preferences—informed by medical evidence and provider expertise—are elicited, integrated and honored,” the report read. “Shared decision making is the process of integrating patients with medical evidence to achieve high quality medical decisions.”
Current research suggests that providers are far more likely to discuss the potential benefits of health interventions than the potential risks and rarely ask for patient preferences, according to the report. This is despite indications that the majority of patients want providers to listen, tell the truth about diagnoses, discuss risks of treatment options and discuss how treatment options may affect quality of life. Correcting the situation will require patient access to the best available medical evidence, unbiased health counseling based on clinical experience and a willingness to elicit and honor patient preferences.
These conclusions were based on polls of patient focus groups and roundtable meetings, which also led to the development of specific phrases for providers to use that may be particularly effective. These include:
- “Making sure you get the best possible care starts with you and your doctor making the best decision for you;”
- “Understand the best types of care based on the most recent medical evidence;”
- “Your doctor needs to listen to you, understand your needs and concerns, and answer your questions;” and
- “Every patient is different.”
“Successful messages include framing messages in a positive way, embedding discussions of medical evidence in the context of a strong relationship with a trusted provider, using language that conveys to patients that the focus is on them and expressing that the goal is to provide patients with the best possible care,” the report read.
There are three key areas where action is required to improve patient-centered care enabled by patient-provider communication, according to the report. Healthcare culture must be redesigned to encourage the practice of informed medical decision making among providers, various stakeholders’ incentives must be aligned to facilitate informed medical decisions and appropriate quality measures should be enacted to hold providers accountable to a standard that requires patients have access to medical evidence.
“By focusing on these target areas in patient engagement, clinician stewardship, institution and policy facilitation, and research promotion, those dedicated to improving evidence communication can realize a profound and immediate opportunity to improve the health of Americans,” the report concluded.
The report is available in its entirety from the IOM.