Using a combination of technological tools, videos, and surveys, clinicians and patients at UCLA are undertaking shared decision-making in several treatment areas.
UCLAs Department of Urology began offering a shared decision-making tool for men with prostate cancer in 2013. Department staff plug in data about the patients diagnosis, such as the aggressiveness score of the tumor, test results, age, race and other medical conditions--all things that could affect the treatment decision. After a patient completes a 15-minute survey regarding their preferences, the resulting report is sent to the doctor ahead of the scheduled consultation, during which the physician and patient meet to discuss the options.
In addition, a more elaborate shared decision-making program is underway at UCLA for patients with painful chronic conditions, such as hip or knee arthritis, spinal stenosis or herniated disc. UCLA is one of 20 participants in a national study on shared decision-making called the High Value Healthcare Collaborative. Funded by the Centers for Medicare and Medicaid Services and led by researchers at Dartmouth College, the study is a rigorous test of the potential benefits of shared decision-making.
Study participants watch a video that was produced for the study. The video depicts actual patients who discuss their condition and how they arrived at their various choices. The video also describes treatment options and the pros and cons of each. After watching the video, patients participate in a 45-minute-telephone or in-person discussion with a health coach who helps them distill the information. After the session, the health coach enters notes in the patients file to inform the physician of which treatment option the patient is leaning toward. But no decision is made until the doctor and patient confer.
In the area of reproductive health at UCLA, Aparna Sridhar, M.D., assistant clinical professor in UCLAs Department of Obstetrics and Gynecology, recently launched an iPad app that she developed during her fellowship at UCLA to help women make informed choices about birth-control methods. The free app, called Plan A Birth Control, takes women through the lengthy and complex list of reversible contraceptive methods, pointing out the pros and cons of each and how they work.
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