DGIM Generally Speaking

Introducing the Informed Medical Decisions Program

	(L to R): Jack Fowler, PhD, Suzanne Brodney, PhD, Michael Barry, MD

The Informed Medical Decisions Program (IMDP) was established in April 2017 with a generous three-year grant from Healthwise, a nonprofit organization with a mission to help people make better health decisions. The IMDP is housed within the Health Decision Sciences Center (HDSC) in the Division of General Internal Medicine. The vision of the IMDP is to inform and amplify the patient’s voice in health care decisions and we plan to accomplish this through research projects focused on the IMDP’s core areas of investigation: 

• Proving the value of tools and solutions for patient engagement.
• Extending the science of measuring decision quality.
• Assessing optimal ways to ensure people are informed and involved in their health and health care. 

The IMDP will work closely with the HDSC to maintain existing and develop new decision quality measures, and act as the steward for measures submitted to the National Quality Forum for national endorsement. We will also collaborate with others at MGH and elsewhere to seek external funding for research to advance the mission. The research we will pursue is focused on the key elements of assessing how medical decisions are made. To learn more about our projects, please visit the HDSC website at http://www.massgeneral.org/decisionsciences. 

The IMDP continues the work of the Informed Medical Decisions Foundation, which was founded in 1989 with the same vision and mission. The Informed Medical Decisions Foundation merged with Healthwise in 2014. 

Who is involved? 

In April, Michael Barry, MD, returned full-time to MGH to direct the IMDP. Floyd ‘Jack’ Fowler, PhD, who was a founding member of the Informed Medical Decisions Foundation, serves as a Senior Scientific Advisor. Suzanne Brodney, PhD, was hired as a full-time Senior Program Manager and Karen Sepucha, PhD, is supported to expand her work in decision quality. We are working on developing mentoring relationships with post-doctoral trainees focused on shared decision making in new health populations and to address health disparities. 

Here’s a selection of projects we are working on: 

• Evaluation of new payment models for shared decision making through Medicare.
• Evaluation of the effects of decision support materials on unhealthy alcohol use, delivered electronically via the secure Epic patient portal.
• Exploration of patient and clinician attitudes about using electronically-generated reports of patients’ values and treatment preferences that are included in the EMR.
• Implementation and evaluation of a certified patient decision aid in clinical practice for women considering birth options after a prior cesarean.
• Evaluation of decisions of potential jurors in scenarios where a woman had an adverse obstetric outcome to test if use of a patient decision aid reduces medical liability exposure. 
• Validation of two patient-focused behavior change outcome measures.
• Participation in a trial funded by the VA to assess patient and surgeon preferences for AAA repair and whether decision aids help elicit patient preferences. 
• Collaboration on a proposal using a shared decision making approach to reduce overscreening for cancer.

We look forward to collaborating with you!

Read more articles from the Fall 2017 edition of Generally Speaking