How EHR Embedded Shared Decision Making Tools Increase Quality of Care

Medical | Jon Keevil| June 11, 2019

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Find out how EHR embedded shared decision making tools can help clinicians present personalized recommendations for a particular decision, leaving more time for productive patient conversations.

In order to conduct a successful conversation with a patient about a medical decision, a clinician should help the patient understand the benefits and harms of the medication or test under consideration. Describing these elements is a key part of shared decision-making (SDM), which can present clinicians with daunting tasks. For some decisions, accurate representation of benefits and harms requires assembling patient-specific data, running sometimes complex calculations and navigating decision logic specific to this patient, then presenting all this information to the patient in a logical, understandable format. This is where EHR (electronic health record) embedded tools can amplify a clinician’s ability to work through decisions with patients by presenting personalized information based on the patient’s medical history.

Traditional reference material includes the guidelines that exist for many of these decisions under consideration. Typically, guidelines are created by large committees of experts working for years to analyze the many details that impact particular decisions. The resulting product is a multi-page document often stuffed with detailed instructions for risk calculations and logic diagrams to address many different patient segments. While these make the guideline more comprehensive for a population, they add complexity and make it harder for the clinician to find the best recommendations for each patient. After publication, these guidelines are often added to a website with no direct pathway to influence medical care. Integrating guidelines into SDM tools brings them directly to the fingertips of the clinician, making the tasks less daunting.

EHR embedded tools can amplify a clinician’s ability to work through decisions with patients by presenting personalized information based on the patient’s medical history.

With effective embedded shared decision making tools, these steps can be completed largely in the background and quickly navigated by the clinician before the conversation starts. The clinician can see the best recommendations for a specific patient with less time and energy invested at the start of the visit. The hope is that the conversation starts with a clinician who has a little more bandwidth available to support the decision process of the patient. 

By combining the efficiency of EHR embedded tools and the deep knowledge represented by a published guideline, the original intent of guidelines is better realized. By bringing this knowledge to the point of care in an easy-to-understand platform, we can help achieve goals of making the best personalized recommendations and reducing unwanted care variation.

Visit the HealthDecision® product page where you can learn more about EHR embedded shared decision making tools for a variety of conditions.

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Jon Keevil

Jon Keevil, MD, FACC is the Founder of HealthDecision and the Vice President of Clinical Decision Support for EBSCO Health. Jon holds a double degree in computer science and engineering from Brown University and an MD from the University of Rochester. He completed his clinical residency and cardiology fellowship at the University of Wisconsin-Madison. Jon practiced medicine for 16 years as a member of the cardiology faculty at the University of Wisconsin Hospital and Clinics. He is a published author of risk prediction research who taught over 2,000 students at the UW School of Medicine and Public Health. Jon built the first HealthDecision tool to facilitate his own patient care at UW and integrated the tools into UW’s EHR in 2010. He left his clinical practice in July 2016 to focus full time on making more clinical decision support tools. 

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