The Informed Medical Decisions Foundation has branded the month of March “Shared Decision Making Month,” and, in an effort to more greatly promote shared decision making (SDM), 5 RAND researchers conducted interviews to determine what factors currently barricade SDM implementation.
The researchers questioned 8 different primary care organizations that are participating in a three-year demonstration, and found a variety of factors contribute to implementation issues including physician workload and training as well as insufficient information systems.
Physicians within the demonstration, even when reminded, still only extended shared decision making aids to 10-30% of their patients, and many physicians were unaware that their current tactics didn’t qualify as “shared decision making.”
Additionally, even if physician-barriers to SDM were corrected, information systems largely lack the ability to track whether patients actually use the aids they are given. It isn’t enough to simply present patients with shared decision making materials; they need to be persuaded to actively participate in their health decisions.
Therefore, researchers suggest ways providers can attempt to combat these barriers. For example, by using automated triggers – pre-determined situations or conditions in which patients “automatically” receive a shared decision making aid. They also suggest properly training physicians to promote shared decision making and to get other clinical staff engaged in the process as well.