More patient involvement in decision making could help reduce health costs
Posted by on March 1, 2013 - 3:30pm

There is growing evidence that the more engaged patients are in their health care decision, the better the outcomes.    Much research -- including several studies published in the current issue of Health Affairs -- found that patients with the lowest involvement in their care  had average costs 8% higher than those with the highest range on an activation (involvement) scale.

But doctors still aren't using that information to their advantage and better engaging patients, panelists at a recent  Institute of Medicine (IOM) workshop on patient engagement said.   More resources need to be invested in getting physicians and healthcare systems to increase patients' involvement in decisions about their care, advocates said here.

"We just haven't spent enough time helping clinicians develop these skills," Eric Holmboe, MD, chief medical officer at the American Board of Internal Medicine, said.

Despite the availability of continuing medical education (CME) courses for physician  in the topic of patient engagement, few are attending them.

Monday's IOM workshop follows a report last month that found Americans live sicker lives and die younger than those in other countries despite the impression that the US has the greatest health care in the world. Many believe there is the need to change the physician culture and convince doctors to accept a greater dialogue with patients, and a representative of GroupHealth, a health plan in Seattle, described his plan's successful patient engagement initiative.

The provider organization, which serves 600,000 Washington residents, undertook a multi-pronged program that included offering patient education on joint-replacement surgeries and alternatives. They offered a half-day CME opportunity on how to discuss options with patients and emphasized to physicians that this was a patient safety issue.

GroupHealth experienced a 26% drop in the number of hip replacements and a 12% to 21% cost reduction after 3-plus years in the program, David Arterburn, MD, MPH, of GroupHealth, said.

Jonathan Welch, MD, Harvard Medical School, said providers need to find better ways to listen to patients and their families. He said the healthcare sector, unlike other service industries, doesn't listen well to feedback from its consumers.

Excerpted from MedPage Today, Feb. 25, 2013 by David Pittman

'This Is Personal' Campaign for Women's Reproductive Rights
Posted by on September 27, 2012 - 9:55am

The 2012 election cycle has seen unprecedented coverage (and often misinformation) on women’s reproductive health care due to the Affordable Care Act’s immediate impact and nonstop campaign gaffes related to women’s health.

Last Thursday, the National Women’s Law Center (NWLC) launched a new campaign to improve access to women’s health information called This Is Personal. The mission of the campaign is to target, engage and inform younger women about reproductive rights and help disseminate information related to women’s health topics ranging from contraception, maternity care, and what Congress is presently voting on.

It is therefore vitally important that women get involved in the decision-making process to ensure that the women impacted by these deeply personal issues have real world input.  “Decisions about women’s reproductive health are personal. Period.” said NWLC Co-President Marcia Greenberger. “These decisions should be a woman’s to make with the important people in her life. The personal beliefs of lawmakers should not trump a woman’s ability to take care of her health.” Despite the private nature of decisions impacting reproductive health care, they are often made at the federal, state or local levels instead of the individual level.

The This Is Personal campaign hopes that through social media, celebrity involvement in videos and satire, young women (and men) will become increasingly active and interactive about reproductive rights. For example, through the new website’s interactive action tabs women can gather more information about state and federal health care decisions, sign petitions and contact legislators.

Decisions about women’s reproductive health care are greatly personal and deserve intimate involvement from women themselves. This Is Personal has a Facebook, Twitter and website with data and satirical videos which should be used as an educational tool and a place for women to educate themselves for the upcoming election. It is also a place where women can actively use their beliefs and knowledge to have their voices heard by decision makers.  Sharing of ideas and knowledge is the only way to put decision making into the hands of the women who will be affected by the policies of the 113th Congress.

Step-by-step Decisions Lead to Smarter Treatment Choices
Posted by on April 25, 2011 - 8:57am

Choosing a treatment option for breast cancer can be almost as confusing and frightening as the diagnosis itself. But it doesn’t have to be. A new study from the University of Michigan has found that women make smarter choices about treatments when they receive information and make decisions in small doses rather than all at once.

The researchers wanted to know if asking women to make a series of simpler choices instead of one complex decision would help them better understand the benefits of each treatment. In the study, researchers asked two groups of women to choose between different breast cancer treatment options. The first group got all the information and made all the choices at once. The second group received the same information, but it was divided into two separate choices: First they chose whether to take hormonal therapy, and if they said yes, then they decided whether or not to add chemotherapy.

The women who received the treatment options all at once were more likely to be confused by the information, and more of them chose chemotherapy regardless of whether it would give them a benefit of 1 percent or 5 percent. But the women who made their decisions separately were more likely to choose chemotherapy only if it would give them a larger benefit.

By presenting information piece-by-piece, doctors can help ensure that patients truly understand the benefits before they choose an aggressive treatment like chemotherapy, said Brian Zikmund-Fisher, study author and assistant professor at the University of Michigan School of Public Health. To read the full study, click here.