This is Dr. Michael Barry's presentation given at the Feb. 14, 2011 Alliance for Health Reform Briefing.

1. Shared Decision MakingWe’re in This Together Michael J. Barry, MDPresident

2. We Believe Patients Should Be

3. Why Shared Decision Making in Health Care?

4. Evidence of the Problem The DECISIONS StudyA Portrait of How Americans Make Common Medical Decisions Medical Practice Variation 40 Years of Research Documenting Inconsistent Care

5. Patients: Making Decisions in the Face of Avoidable Ignorance Clinicians: Poorly “Diagnosing” Patients’ Preferences Poor Decision Quality

7. They share information

8. About options and outcomes

9. About preferences

10. They work toward a consensus about the preferred test or treatment

11. They reach an agreement on the test or treatment to implement(Charles C, Soc Sci Med 1997; 44:681)

13. Both patients and physicians support SDM

14. Implementation models are demonstrating that SDM can work “in the trenches”O’Connor et al. Cochrane Database of Systematic Reviews, 2009

16. Shared Decision MakingTRENDS

17. Patient Protection and Affordable Care Act HR3590 Section 936 Program to Facilitate Shared Decision Making To facilitate collaborative process between patients and providers .. and to incorporate patient preferences and values into medical plan Authorized not Appropriated

18. Key Aspects of PPACA Section 936 Produce patient decision aids Set quality standards and certify decision aids Create Shared Decision Making Resource Centers Grant funds to providers for development, use and assessment of SDM techniques using certified decision aids

19. Section 3021 CMS Innovation Center Test innovative payment models to reduce expenditures and to enhance quality of care Option #9 Assisting applicable individuals in making informed health care choices by paying providers for using patient decision support tools that improve individual understanding of medical options Section 931 Quality Measures Development Assessment of experience, use and quality of information provided to patients to inform decision making including the use of SDM tools

21. Accountable Care Organizations