Shared Decision Making in
Practice at MGH 
MGH Health Decision Sciences Center

April, 2015
Issue 13
In This Issue

Top 10

Video Programs:

prescribed last quarter 

 (January-March) 

 

  1. Sleeping Better: Help for Long-Term Insomnia
  2. Treatment Choices for Knee Osteoarthritis 
  3. Help for Anxiety: Treatments that Work
  4. Coping with Symptoms of Depression  
  5. Is a PSA test Right for You? 
  6. Treatment Choices for Hip Osteoarthritis 
  7. Peace of Mind: Personal Stories about Advance Directives
  8. Acute Low Back Pain: Managing Your pain through Self-Care
  9. Living with Diabetes: Making Lifestyle Changes to Last a Lifetime 
  10. Herniated Disc: Choosing the Right Treatment for You 
SDM Toolkit
For a useful Shared Decision-Making "toolkit" including helpful hints and FAQs,visit the MGH Excellence Every Day website.

Welcome to the Shared Decision Making (SDM) program newsletter. In this newsletter you will find: updates to the available video programs, new shared decision making projects, practice-specific prescription data, upcoming events, and useful resources and links.


The Shared Decision Making Program is sponsored by the MGH Health Decision Sciences Center, The John D. Stoeckle Center and the Massachusetts General Physicians Organization. We strive to provide high-quality health information to promote active and shared decision-making in clinical care at the Massachusetts General Hospital.

 

We appreciate your feedback as we continue to expand and improve upon our program work.


 

Sincerely,

Karen Sepucha, Leigh Simmons, Lauren Leavitt,

Felisha Marques, Sarah Hewitt, Mahima Mangla, Sharon Floramo, EmilyWendell 


 

 Depression Care 

  

Several practices have started projects in mental health  using our three mental health decision aids, Depression, Anxiety, and Insomnia. The projects in Women's Health, Senior Health, Back Bay, and the IMA have led to a 4-fold increase in use of these topics compared to last year.  Here are some of the clinicians' reactions and experiences:

 

"The SDM materials on depression help patients understand the disorder and treatment options.  Use of the materials is associated with adherence to treatment, and thus good outcomes.  Patients report they appreciate having been introduced to the materials.  So I encourage all those treating depressed patients, in the Primary Care and Mental Health settings, to use depression SDM packets." -Jeffrey Weilburg

 

"I sent one of my patients the Insomnia/Sleeping better DA, and during our follow up call, she raved about it. She noted that she shared it with her husband because they were both under the perception that drinking prior to bed would help them fall asleep. She read the DA and learned otherwise, and has since discontinued this, and has already seen some improvement in her sleep." -Haley Marshall

 

"These resources have been very well received by the patients and it's been great having something to offer them to help them cope/deal with these chronic issues."-Carine Luxama

 

We just launched an evaluation component and will survey all patients who receive the depression decision aid to examine the impact of the program on their understanding of the disease and their treatment preferences. 

Ten Years of SDM at MGH
 

We continue to celebrate the 10 year anniversary of Shared Decision Making program at MGH.  The purpose of the program was to figure out how to integrate patient decision aids into routine care and it started as a small pilot in the IMA. It was soon expanded to all primary care practices, and more recently to several specialty practices.

 

For this newsletter, we wanted to share a little of the history of shared decision making and its origins at MGH. We reached out to Dr. Al Mulley, to get his reflections as one of the pioneers in this field. As most of you know, Al was the founding Chief of the General Medicine Division at MGH and also co-founder of the Informed Medical Decisions Foundation. He helped develop the first patient decision aids back in the 1980s, and the decision aids we use across Partners today are based on his work. When we asked him to define shared decision making, he replied:

 

"Many people equate shared decision making with sending a video or other form of decision aid, but that's only a small piece. Shared decision making is a dialogue between health care providers and patients facing a particular health issue.  It is about helping patients understand what is possible based on available evidence - describing both the good and bad outcomes - and then supporting patients by making sure the treatments they receive reflect what matters most to them. By emphasizing both evidence and patients' preferences, shared decision making helps us deliver the care that patients need and no less, and the care they want and no more." 

 

Since joining the faculty at Dartmouth in 2010, he has been leading the Center for Health Care Delivery Science and has been taking this mission across the globe.  

Updated LMR Interface Coming Soon!  
  

We are excited to announce an updated LMR interface for patient decision aid ordering. On May 20th, LMR plans to release an update that allows all LMR users across Partners Healthcare System to order programs. The 3-click process will remain the same, but it will look a bit different. 

 

Access to the ordering page will still be on the "Summary" tab  in the patient's chart, but the  "Videos/DVD" label will be replaced with "Patient Decision Aids." See the screenshot below.  The new LMR application will also default to send the decision aid to the patient via Patient Gateway. We will continue to mail the DVD and booklet to patients who are not signed up for the Patient Gateway portal.   

 

Please share this information with staff or others who place orders  for the decision aids in your practice.  This new launch provides a great opportunity to increase the use of the patient decision aids as we continue to spread shared decision making awareness across the Partners Population Health Management Patient Engagement initiative.


Clinician Workshop
 

Make Your Own Decision Aid!

Is there a topic that you wished had a decision aid? The SDM team will be hosting a workshop "How to create a Decision Worksheet" on June 11th from 5pm-7pm. The Decision Worksheet is a short paper-based decision aid designed to support shared decision making during a visit.  In this workshop, we will go through steps for creating one on a topic that you choose.  If you are interested in attending, please RSVP to [email protected].

Video Prescription Data
 
Take a look!  Here is a quick view of the shared decision-making video prescription data from the last quarter (Jan-Mar, 2015).  We've provided an update to other practices across MGH.
Upcoming Events 
  
The Blum Center at MGH hosts monthly patient education sessions including the presentation of a shared decision making video followed by a facilitated discussion. The one-hour session, 12:00-1:00pm,  is open to MGH patients and staff.

May 27th, 2015: Coping with Symptoms of Depression

Contact us to provide suggestions for future session topics.

* 40 Patient Decision Aids are Available to Order *

   

For a full listing of the 40 available Shared Decision Making decision aids, click here!

All of the SDM one-page information sheets can now be quickly accessed through PCOI.
  
If you think your patients would be interested in viewing a video program online, contact our team. We can work with you to provide this access to patients.