Patients in Health Decisions
|
|
|
- Bridget Houston
- 6 years ago
- Views:
Transcription
1 Strategies for Engaging Patients in Health Decisions Laura Boland, MSc, SLP-C, PhD(c) Population Health University of Ottawa October 19 th, 2016
2 Overview Shared decision making Decision coaching Patient decision aids Simulated encounter Discussions
3 Getting Started What are some difficult health decisions that patients face in your practice? owhat makes them difficult? ohow can we support patients?
4 What Makes Decisions Hard? The Grey Zones! Benefits of 3000 health interventions Editorial team of BMJ Clinical Evidence
5 Supporting Patients: Patient Engagement Figure from: Carmen 2013
6 Paternalistic (Doctor/Team Decides) Shared Decision Making Autonomous (Patient Decides) Shared decision making (SDM) represents a middle ground where both the clinician and the patient partner in making the decision.
7 Information exchange: 2 experts Two way flow of information Partner in reaching agreement on the best treatment plan
8 Steps Legare et al., 2010
9 Why Shared Decision Making? Ethical and legal imperative Patient safety and high quality service delivery Unwarranted practice variations Improves patient outcomes Less likely to blame healthcare providers for poor outcomes Promotes optimal decisions in situations where results cannot be guaranteed O Connor 1998, 2003; Bekker 1999; Wennberg 2002; Keisler & Auerbach, 2006
10 Relevance to Nurses/ HCP Patients want nurses to: Advocate for them Mediate and explain information Listen to patient preferences Communicate patient preferences to physician and healthcare team Decision coaches Joseph-Williams, 2014
11 Decision Coaching Clinical strategy to support SDM with patients facing decisions where there is not one best answer
12 Decision Coaching o Trained healthcare professional o Help guide patient through decision making process o Non-directive and individualized guidance o Evidence: patient knowledge participation satisfaction Stacey et al., 2013
13 Patient Decision Aids Clinical tools to facilitate SDM
14 Patient Decision Aids Inform o A decision point o Evidence/facts: condition, options, benefits, harms o Communicate probabilities Clarify values o Patient experience o Benefits/harms matters most o Facilitate communication Support a process o Guide in steps in deliberation/communication o Provide worksheets, list of questions Stacey et al., 2014 Cochrane Review
15
16
17
18
19
20 Exercise and Discussion
21 Groups of 2 or 3 Person #1: think of a real decision Person #2: support decision making process using the OPDG Other: Observe
22 Discussion Do you think decision coaching with the PtDA changed the conversation? What did you like or dislike about the OPDG? Other comments?
23 Topics in Decision Aids Trials (N=115) Medication (n=36) 10 hormone replacement therapy 3 atrial fibrillation anti-coagulants 3 cardiovascular 3 diabetes 2 osteoporosis 2 chemotherapy 2 breast cancer prevention 2 osteoarthritis knee Hypertension Screening (n=46) 15 Prostate Specific Antigen (PSA) 7 BRCA1/2 genetic 11 colon cancer 6 prenatal 2 mammography 2 diabetes Colon cancer genetic Cervix cancer Stress testing for chest pain Surgery (n=23) 4 mastectomy +1 reconstruction 4 prostatectomy 4 hysterectomy 2 prophylactic BRCA1/2 2 coronary revascularization dental orchiectomy for advanced prostate ca Back Obstetrics (n=6) 2 vaginal birth after cesarean termination breech labour analgesia embryo transplant Other (n=4) Hepatitis B and influenza vaccine Autologous blood donation Cystic Fibrosis Transplant Referral Stacey et al., 2014 Cochrane Review
24 Impact Patient Decision Aids Improve decision quality 14% higher knowledge scores 79% more accurate risk perception 49% better match between values & choices Reduce decisional conflict (6%) Help undecided to decide (41%) Patients less passive in decisions Potential to reduce overuse 20% surgery 14% PSA 27% HRT Stacey et al., 2014 Cochrane Review
25 Decision Aid Formats 1. Print Passive or interactive 2. DVD/Video Passive 3. Online/computerbased Passive or interactive Stacey et al., 2014 Cochrane Review
26 Condition Specific Decision Aids International Patient Decision Aid Standards (IPDAS) Collaboration To enhance the quality and effectiveness of patient decision aids by establishing a shared evidenceinformed framework for improving their content, development, implementation, and evaluation. IPDAS Steering Committee: Glyn Elwyn & Dawn Stacey (Co-Leads), M Barry, N Col, A Coulter, K Eden, M Härter, M Holmes-Rovner, H Llewellyn-Thomas, V Montori, N Moumjid, M Pignone, R Thomson, L Trevena, R Volk, T van der Weijden Stacey et al., 2014 Cochrane Review
27
28 Using Decision Aid in Practice: Video Exercise
29 OPTION tool The clinician draws attention to an identified problem as one that requires 1 a decision-making process Yes No The clinician states that there is more than one way to deal with the identified problem 2 ( equipoise ) Yes No The clinician assesses patient s preferred approach to receiving information 3 to assist decision making (e.g. discussion, read printed material, assess graphical data, Yes No drawings, use videotapes or other media) 4 The clinician lists options, which can include the choice of no action Yes No The clinician explains the pros and cons of options to the patient (taking no action is an 5 option) Yes No The clinician explores the patient s expectations (or ideas) about how the problem(s) are to 6 be managed Yes No The clinician explores the patient s concerns (fears) about how the problem(s) are to be 7 managed Yes No 8 The clinician checks that the patient has understood the information Yes No The clinician offers the patient explicit opportunities to ask questions throughout the 9 decision-making process Yes No 10 The clinician elicits the patient s preferred level of involvement in decision making Yes No 11 The clinician indicates the need for a decision making (or deferring) stage Yes No 12 The clinician indicates the need to review the decision (or deferment) Yes No Elwyn et al, 2003
30 Discussion What behaviours described in the OPTION grid did you observed during the clinical encounter?
31 Key Messages To engage patients in shared decision making: Make explicit the decision Provide balanced information on options Ask patients what matters most TO MAKE SHARED DECISION MAKING A HABIT, PRACTICE IT EVERYDAY
32 Wrap up Thank you!
33 Surgery with lower mortality rate / higher likelihood of colostomy Effect of Doctor, what would you do? 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Colon Cancer Surgical Decision 76% 62% Choice for patient Choice for self Conclusion: Physicians make different choices for themselves than for their patients. Ubel et al, 2011
34 Informed consent vs SDM Patient/HCP discussion about treatment options Informed consent process Shared decisionmaking (SDM) Risks and benefits Options / alternatives Probabilities of various outcomes Clarification of patient values, preferences and personal situation May use a decision aid to help inform and guide decision Informed choice made in partnership between patient / family and HCP Page, 2015
35 When are Decision Aids Used?
Engaging patients and their family in shared decision making
Engaging patients and their family in shared decision making @d_stacey. Dawn Stacey RN, PhD, CON(C) Research Chair, Knowledge Translation to Patients Professor, University of Ottawa Senior Scientist, Ottawa
Shared Decision Making, Ethics, and Shared Responsibility
Shared Decision Making, Ethics, and Shared Responsibility Ben Moulton, JD, MPH Senior Legal Advisor Lecturer in Health Law, Harvard School of Public Health September 29, 2011 Shared Decision Making (SDM)
Shared Decision Making in Clinical Practice
Shared Decision Making in Clinical Practice November 20, 2017 Karen Sepucha, PhD; Leigh Simmons, MD; Lauren Leavitt, MA; Felisha Marques, MPH MGH Health Decision Sciences Center www.massgeneral.org/decisionsciences/
Don t just listen, Co-produce! November 18 th 2013 Swales stadium
No decision about me without me Implementing Shared Decision Making into clinical practice Ann Jones Continuous Service Improvement Team, Cardiff and Vale UHB Don t just listen, Co-produce! November 18
Webinar Series. Effective and Compassionate Communication for Informed, Shared Decision-Making Tuesday, May 12, Audience Reminders
Webinar Series Effective and Compassionate Communication for Informed, Shared Decision-Making Tuesday, May 12, 2015 Audience Reminders This webinar is funded in part by a donation in memory of Julian and
National Standards for Patient Decision Aids: CSAC Meeting
National Standards for Patient Decision Aids: CSAC Meeting July 13-14, 2016 NQF Project Team Helen Burstin, MD, MPH Chief Scientific Officer Sarah Sampsel, MPH Senior Director Andrew Anderson, MHA Project
Leveraging Shared Decision Making to Manage Population Health Partners HealthCare s Lessons Learned Gloria Stone Plottel, MS, MBA, Founder and CEO,
Leveraging Shared Decision Making to Manage Population Health Partners HealthCare s Lessons Learned Gloria Stone Plottel, MS, MBA, Founder and CEO, GSPsquared LLC Adam Licurse, MD, MHS, Associate Medical
Shared Decision Making When there is more than one right option
Shared Decision Making When there is more than one right option To write prescriptions is easy, but to come to an understanding with people is hard. Franz Kafka, A Country Doctor 1 2 PATIENT- AND FAMILY-CENTERED
SHARED DECISION MAKING
SHARED DECISION MAKING THE PINNACLE OF PATIENT- CENTERED CARE Bree Collaborative Meeting Benjamin Moulton JD, MPH Senior Legal Advisor Lecturer in Health Law HSPH Boston University Law School Foundation
An Introduction Shared Decision Making in Clinical Practice
An Introduction Shared Decision Making in Clinical Practice Brought to you by: Objectives Understand the key components and principles of SDM Learn about the patient and provider experience with SDM Consider
Shared Decision Making
Shared Decision Making No decision about me, without me Pharmac Seminar Series Medicines in Healthcare August 2015 This Session Introduction to SDM what & why (disclaimer) Essential elements Communicating
Shared Decision Making
Shared Decision Making WHY PATIENTS PREFERENCES MATTER Angela Coulter Director of Global Initiatives November 2012 Outline Why patients preferences matter Shared decision making Personalised care planning
With any surgery, consent
Perspective Informed Patient Choice: Patient-Centered Valuing Of Surgical Risks And Benefits The perceived barriers to understanding patients values around elective surgical procedures are not insurmountable.
Shared Decision Making, Ethics and Shared Responsibility. Ben Moulton JD, MPH Senior Legal Advisor Lecturer in Health Law HSPH
Shared Decision Making, Ethics and Shared Responsibility Ben Moulton JD, MPH Senior Legal Advisor Lecturer in Health Law HSPH We Believe Patients Should Be Supported & encouraged to participate in their
Treatments with adequate scientific evidence about outcomes
Individual Level Toward The Tipping Point : Decision Aids And Informed Patient Choice Access to high-quality patient decision aids is accelerating, but not at the point of clinical care. by Annette M.
Engaging patients using an interprofessional. approach to shared decision
CANO conference feature Engaging patients using an interprofessional approach to shared decision making by Dawn Stacey and France Légaré ABSTRACT Many cancer treatment and screening decisions are difficult
Law, Shared Decision Making & Health Disparities
Law, Shared Decision Making & Health Disparities Ben Moulton, J.D., MPH Senior Legal ladvisor, FIMDM Lecturer in Health Law, Harvard School of Public Health Practice Variation: Evidence for Poor Decisions
Shared Decision Making in Clinical Practice
Shared Decision Making in Clinical Practice February 19, 2014 Presenter Dr. Larry Morrissey, MD, FAAP Central Pediatrics, Woodbury, MN 2 1 An Introduction: Shared Decision Making in Clinical Practice Brought
SHARED DECISION MAKING WHY PATIENTS PREFERENCES MATTER
SHARED DECISION MAKING WHY PATIENTS PREFERENCES MATTER HONG KONG HOSPITAL AUTHORITY CONVENTION 2013 ALBERT MULLEY, MD, MPP MEMBER, INSTITUTE OF MEDICINE, NATIONAL ACADEMY OF SCIENCES DIRECTOR, THE DARTMOUTH
Modifying Unwarranted Variations In Health Care: Shared Decision Making Using. Patient Decision Aids
Patient Decision Aids Modifying Unwarranted Variations In Health Care: Shared Decision Making Using Patient Decision Aids A review of the evidence base for shared decision making. by Annette M. O Connor,
PATIENT- CENTERED CARE: BOTH IN INDIVIDUAL CONVERSATIONS WITH PATIENTS AND IN PRACTICE TRANSFORMATION EFFORTS
PATIENT- CENTERED CARE: BOTH IN INDIVIDUAL CONVERSATIONS WITH PATIENTS AND IN PRACTICE TRANSFORMATION EFFORTS Integrated Network Engagement Summit 9/21/17 Aimee English, MD OVERVIEW Engaging patients
Schedule of Benefits - Indemnity Group - MEDFORD AREA SCHOOL DISTRICT Benefit Year: January 1st through December 31st Effective Date: 01/01/2016
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
Schedule of Benefits - HMO Group - MEDFORD AREA SCHOOL DISTRICT Benefit Year: January 1st through December 31st Effective Date: 01/01/2016
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
Rural-Relevant Quality Measures for Critical Access Hospitals
Rural-Relevant Quality Measures for Critical Access Hospitals Ira Moscovice PhD Michelle Casey MS University of Minnesota Rural Health Research Center Minnesota Rural Health Conference Duluth, Minnesota
Kaiser Permanente Group Plan 301 Benefit and Payment Chart
301 Kaiser Permanente Group Plan 301 Benefit and Payment Chart 10119 CITY AND COUNTY OF SAN FRANCISCO About this chart This benefit and payment chart: Is a summary of covered services and other benefits.
Schedule of Benefits - Point of Service MOSINEE SCHOOL DISTRICT Benefit Year: January 1st Through December 31st Effective Date: 07/01/2016
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
Risk Evaluation and Mitigation Strategies: Improving Benefit-Risk Counseling Between Providers and Patients 4/14/2016
Risk Evaluation and Mitigation Strategies: Improving Benefit-Risk Counseling Between Providers and Patients 4/14/2016 1 Gary Slatko Sara Eggers U.S. Food and Drug Administration 2 Goals for Today s Meeting
Isabelle Scholl 1,2*, Allison LaRussa 1, Pola Hahlweg 2, Sarah Kobrin 3 and Glyn Elwyn 1
Scholl et al. Implementation Science (2018) 13:40 https://doi.org/10.1186/s13012-018-0731-z SYSTEMATIC REVIEW Open Access Organizational- and system-level characteristics that influence implementation
Opportunities for the Use of Decision Aids in Primary Care
350 May 2009 Family Medicine Clinical Research and Methods Opportunities for the Use of Decision Aids in Primary Care Linda Hill, MD, MPH; Mary-Rose Mueller, PhD, RN; Stergios Roussos, PhD, MPH; Melbourne
Kaiser Foundation Health Plan, Inc. A NONPROFIT HEALTH PLAN - HAWAII REGION
Kaiser Foundation Health Plan, Inc. A NONPROFIT HEALTH PLAN - HAWAII REGION 2019 Summary of Important Changes for Contract Renewals for the Kaiser Permanente Group Plan (These changes are subject to regulatory
Supplemental Table 1. Summary of Studies Examining Interpersonal Continuity and Care Outcome
Online Supplementary Material Saultz JW, Lochner J. Interpersonal continuity of care and care outcomes. Ann Fam Med. 2005;3:15-166. Supplemental Table 1. Summary of Studies Examining Interpersonal Continuity
Dear New Patient, Once again, we would like to thank you for choosing us as your primary health care provider. We look forward to working with you.
307 West Central Street Wendy J. Parker, M.D. Natick, MA 01760 Deborah J. Riester, M.D. Telephone: 508-820-8383 Jo-Ann Suna,M.D. Fax: 508-820-0250 Hadia F. Tirmizi, M.D. Natalia Sedo, N.P. Christine Chang,
Open comparisons of health care performance
Open comparisons of health care performance OECD Workshop on Health Data Governance Max Köster 2015-05-20 NBHW National Board of Health and Welfare Ensure good health, social welfare and care on equal
SERVICES COVERAGE LIMITS/ EXCLUSIONS Alcohol, Drug, and Substance Abuse Services
SERVICES COVERAGE LIMITS/ EXCLUSIONS Alcohol, Drug, and Substance Abuse Services Alcohol, drug, and substance abuse treatment services are provided by the Department of Alcohol and Other Drug Abuse Services
Creating a person-centered transgender care program Kaiser Permanente
Creating a person-centered transgender care program Kaiser Permanente IHI National Forum December 13, 2017 Session E2/D2 These presenters have nothing to disclose. 1 Presenters Erica Metz, MD She/her/hers
SHARED DECISION MAKING
SHARED DECISION MAKING A M G A 2 0 1 3 I N S T I T U T E F O R Q U A L I T Y L E A D E R S H I P Richard Wexler, MD Chief Medical Officer rwexler@imdfoundation.org DISCLOSURE I am employed by the nonprofit
Print Guardian Name (If not patient) DOB: Patients Name: (Last, First, MI): Circle One: - - / / Mailing Address: Apt. #: City: State: Zip Code:
Patients Name: (Last, First, MI): SSN: DOB: Circle One: Male Mailing Address: Apt. #: City: State: Zip Code: Female Race: Ethnicity Primary Language: Home Phone: Preferred? Cell Phone: Preferred? Employer:
Benefits. Benefits Covered by UnitedHealthcare Community Plan
Benefits Covered by UnitedHealthcare Community Plan As a member of UnitedHealthcare Community Plan, you are covered for the following MO HealthNet Managed Care services. (Remember to always show your current
MEDICARE By Peter G. Pan
Wendell K. Kimura Acting Director Research (808) 587-0666 Revisor (808) 587-0670 Fax (808) 587-0681 LEGISLATIVE REFERENCE BUREAU State of Hawaii State Capitol Honolulu, Hawaii 96813 No. 02-13 October 7,
2016 Medical Plan Comparison Chart
2016 Medical Plan Comparison Chart WellStar Health System is committed to helping you control healthcare costs while providing more choices and personal control over your healthcare coverage through the
Covered (blood, blood components, human blood products, and their administration) Covered (Some restrictions)
Washington Apple Health Medical Benefits Allergy Services (Antigen/Allergy Serum/Allergy Shots) Ambulance Services (Air Transportation) by FFS* Ambulance Services (Emergency Transportation) Ambulatory
Can We Lower Low-Value Care? Policy Measures and Lessons in Australia, Canada, England, France, and Germany
Can We Lower Low-Value Care? Policy Measures and Lessons in Australia, Canada, England, France, and Germany Reinhard Busse, Prof. Dr. med. MPH FFPH Dept. Health Care Management, Technische Universität
Leveraging Wellness Visit with Medicare: Improving Income and Patient Outcomes
Leveraging Wellness Visit with Medicare: Improving Income and Patient Outcomes Overview Why Medicare Wellness Exams What are the Medicare Wellness Exams Annual Wellness Exam Components What is covered
National Priorities for Improvement:
National Priorities for Improvement: Standardization of Performance Measures, Data Collection, and Analysis Dale W. Bratzler, DO, MPH Principal Clinical Coordinator Oklahoma Foundation Contracting for
Fast Facts 2018 Clinical Integration Performance Measures
IMPORTANT: LHP providers who do not achieve a minimum CI Score in 2018 will not be eligible for incentive distribution and will be placed on a monitoring plan for the 2019 performance year. For additional
ENVIRONMENT Preoperative evaluation clinic. Preoperative evaluation clinic. Preoperative evaluation clinic. clinic. clinic. Preoperative evaluation
Goals and Objectives, Preoperative Evaluation Clinic Rotation, CA-1 and CA-2 year UCSD DEPARTMENT OF ANESTHESIOLOGY PREOPERATIVE EVALUATION CLINIC ROTATION GOALS AND OBJECTIVES, CA-1 and CA-2 YEAR PATIENT
Minnesota Statewide Quality Reporting and Measurement System: APPENDICES TO MINNESOTA ADMINISTRATIVE RULES, CHAPTER 4654
Minnesota Statewide Quality Reporting and Measurement System: APPENDICES TO MINNESOTA ADMINISTRATIVE RULES, CHAPTER 4654 DECEMBER 2017 APPENDICES TO MINNESOTA ADMINISTRATIVE RULES, CHAPTER 4654 Minnesota
FLORIDA MEDICAL CLINIC, P.A. Your Life, Our Specialty
FLORIDA MEDICAL CLINIC, P.A. Your Life, Our Specialty Consent for Purposes of Treatment, Payment and Health Care Operations I consent to the use or disclosure of my protected health information by Florida
PacifiCare SignatureValue Advantage Offered by PacifiCare of California
CALIFORNIA SMALL GROUP PacifiCare SignatureValue Advantage Offered by PacifiCare of California 30-40/500d HMO Schedule of Benefits Effective March 1, 2010 These services are covered as indicated when authorized
Schedule of Benefits - CENTRAL HMO Group CITY OF MARSHFIELD Benefit Year: January 1st through December 31st Effective Date: 01/01/2017
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
OBSTETRICAL ANESTHESIA
DEPARTMENT OF ANESTHESIA RESIDENCY TRAINING PROGRAM UNIVERSITY OF MANITOBA OBSTETRICAL ANESTHESIA INTRODUCTION Residents will have the opportunity to gain experience in Obstetrical anesthesia in the course
Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide
Your Responsibilities. $2,000 per family. $1,600 per individual $3,200 per family
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
Your Responsibilities. $1,500 per family $250 copayment per visit
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
HOME BANK - S2395 NON-GRANDFATHERED CONSUMER DRIVEN HEALTH PLAN BENEFIT SHEET
CONSUMER DRIVEN HEALTH PLAN BENEFIT SHEET GENERAL PLAN INFORMATION Coordination of Benefits Standard COB Dependents Children birth to 26 180 days from incurred Filing Limit date, except when 180 days would
Shared Decision Making & Patients with Multiple Chronic Conditions
Shared Decision Making & Patients with Multiple Chronic Conditions Sheri Ver Steeg, RN, MSN-HCSM Monica Vail, RN 2012 Mercy Medical Center, Mercy Clinics, Inc. All rights reserved Disclosures Our Shared
Benefit Explanation And Limitations
Benefit Explanation And Limitations SFHP providers supply many medical benefits and services, some of which are itemized on the following pages. For specific information not covered in this table, please
Patient Engagement, Shared Decision Making and PCNA Educational Materials
Patient Engagement, Shared Decision Making and PCNA Educational Materials Kim Newlin, RN, ANP-C, FPCNA Board Member, PCNA April 7 th, 2016 Objectives Identify ways to improve patient engagement at a provider
Wait Time Information in Priority Areas: Definitions
Wait Time Information in Priority Areas: Definitions 1 Background In 2004, Canada's first ministers agreed to work towards reducing wait times for five priority areas: cancer treatment, cardiac care, diagnostic
Benefit Explanation And Limitations
Benefit Explanation And Limitations SFHP providers supply many medical benefits and services, some of which are itemized on the following pages. For specific information not covered in this table, please
How the Overuse of Medical Care is Wrecking Your Health and Your State s Budget
How the Overuse of Medical Care is Wrecking Your Health and Your State s Budget Presentation to the Council of State Governments Eastern Regional Conference Atlantic City, NJ July 22, 2012 Rosemary Gibson,
The health coaching approach: A different way to talk with patients. Dr Andrew McDowell Director of Health Coaching The Performance Coach
The health coaching approach: A different way to talk with patients Dr Andrew McDowell Director of Health Coaching The Performance Coach NHS Institute for Innovation and Improvement, 2013 What is Health
DELAWARE FACTBOOK EXECUTIVE SUMMARY
DELAWARE FACTBOOK EXECUTIVE SUMMARY DaimlerChrysler and the International Union, United Auto Workers (UAW) launched a Community Health Initiative in Delaware to encourage continued improvement in the state
Health Sciences Centre, Team C, Dr. M. Wells (Breast and Hernia) Medical Expert
Health Sciences Centre, Team C, Dr. M. Wells ( and ) Introduction The goal of this rotation is to afford senior residents the best possible opportunity to develop the foundational knowledge and skills
$6,550 per individual $13,100 per family
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
Dr Gale Bearman Brisbane Gender Clinic
Dr Gale Bearman Brisbane Gender Clinic Models of Clinical Care How to people with diverse gender identities obtain clinical care? How can professionals get started in providing clinical care? Wpath Standards
Informed Consent: when autonomy & beneficence collide
Informed Consent: when autonomy & beneficence collide MAWS Conference Seattle WA, May 10 th, 2013 Andrew Kotaska MD, FRCSC Yellowknife, NT, Canada Objectives Autonomy & beneficence Culture of risk Offer,
Introduction. Singapore. Singapore and its Quality and Patient Safety Position 11/9/2012. National Healthcare Group, SIN
Introduction Singapore and its Quality and Patient Safety Position Singapore 1 Singapore 2004: Top 5 Key Risk Factors High Body Mass (11.1%; 45,000) Physical Inactivity (3.8%; 15,000) Cigarette Smoking
Core Metrics for Better Care, Lower Costs, and Better Health
Core Metrics for Better Care, Lower Costs, and Better Health IOM Roundtable on Value & Science-Driven Health Care September 27, 2012 Washington, D.C. Sam Nussbaum, M.D. Executive Vice President, Clinical
New Options in Chronic Care Management
New Options in Chronic Care Management Numbers reveal the need for CCM, as it eases the burden for patients and providers. 2015 Wellbox Inc. No portion of this white paper may be used or duplicated by
UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California
UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California HMO 20 (20/0%) EFFECTIVE JULY 1, 2017 These services are covered as indicated when authorized through your Primary Care Physician
HEALTH CENTER. Can Health Centers Do Differently When It Comes to Patient Engagement?
1 WHY Engage Patients In Care? There is mounting evidence that patient involvement with shared decision making and self-care improves health care quality and outcomes at a lower cost. 1,2,3,4,5,6,7,8 Engaging
UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California
CALIFORNIA SCHOOLS VEBA UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California Performance HMO Schedule of Benefits (Package A, Network 1) 10/0% These services are covered as indicated
MERCY MEDICAL CENTER - DUBUQUE TRADITIONAL PPO PLAN $10/20%/40% RX PROVIDED BY PREFERRED HEALTH CHOICES EFFECTIVE JANUARY 1, 2015
MERCY MEDICAL CENTER - DUBUQUE TRADITIONAL PPO PLAN $10/20%/40% RX PROVIDED BY PREFERRED HEALTH CHOICES EFFECTIVE JANUARY 1, 2015 DEDUCTIBLE, COPAYS/COINSURANCE AND DOLLAR MAXIMUMS facilities and Aligned
Medicare & Medicaid. William Kassler, MD Chief Medical Officer Centers for Medicare & Medicaid Services Boston, MA
Medicare & Medicaid EHR Incentive Program William Kassler, MD Chief Medical Officer Centers for Medicare & Medicaid Services Boston, MA Overview Background / Policy Context EHR Incentive Program basics
Shared Decisionmaking To Improve Patient Safety, Education, and Empowerment
Shared Decisionmaking To Improve Patient Safety, Education, and Empowerment Executive Summary James Madison University (JMU) in Harrisonburg, Virginia, has more than 5,000 student visits each year for
20th Century Health Care 21st Century Health Care
20 th Century Health Care Clinician-centred Patient as passive complier Focus on cure and effectiveness Increase quality More is better Good care for known patients Hospital as focus Public sector bureaucracy
Shared decision-making
Thought experiment Shared decision-making Andy Hutchinson Medicines Education Technical Adviser Stroke Major GI bleeds 2 Wide variation in preferences Alonso-Coello P, et al. (2014). Health Expectations
UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California
CALIFORNIA SCHOOLS VEBA UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California Performance HMO Schedule of Benefits (Benefit Package B, Network 2) 20/500A These services are covered
Summary of benefits Health Net. seniority plus green. Benefits effective January 1, 2009 H0562 Medicare Advantage HMO
2009 Health Net Summary of benefits Los Angeles, Orange, Riverside and San Bernardino counties s effective January 1, 2009 H0562 Medicare Advantage HMO Material ID H0562-09-0041 CMS Approval 9/08 Section
Title: Minimal improvement of nurses' motivational interviewing skills in routine diabetes care one year after training: a cluster randomized trial
Author's response to reviews Title: Minimal improvement of nurses' motivational interviewing skills in routine diabetes care one year after training: a cluster randomized trial Authors: Renate Jansink
HEALTH NET S IT S YOUR LIFE WELLSITE It s Your Life online tools and resources plus the personal support of Decision Power SM
HEALTH NET S IT S YOUR LIFE WELLSITE It s Your Life online tools and resources plus the personal support of Decision Power SM SM TAKING STEPS TO IMPROVE YOUR LIFE Staying healthy while balancing the daily
UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California
CALIFORNIA SCHOOLS VEBA UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California HMO Schedule of Benefits 20/250A These services are covered as indicated when authorized through your
Implementing shared decision making in
Implementing shared decision making in the UK A report for the Health Foundation Angela Coulter, PhD Produced as a scoping paper for the Health Foundation in 2009. Identify Innovate Demonstrate Encourage
UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California
CALIFORNIA SCHOOLS VEBA UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California Performance HMO Schedule of Benefits (Package A, Network 1) 10/0% These services are covered as indicated
Meaningful Use: a Primer
Health Information Technology Extension Center of Los Angeles Meaningful Use: a Primer Mary Mitchell Director of Meaningful Use Defined as: What is Meaningful Use? A. Use of a certified EHR in a meaningful
Corporate Partners Program
Mercy Health Foundation St. Louis Mercy Health Foundation 615 S. New Ballas Road St. Louis, MO 63141 Office: 314-251-1800 Fax: 314-251-1801 mercyhealthfoundation.stl@mercy.net Corporate Partners Program
NAME MEDICAL HISTORY DATE Past Medical History: (Please circle all that apply): NONE Anxiety Coronary Artery Disease HIV/AIDS Seizures Arthritis Depre
GENERAL INFORMATION Patient Name Preferred Name of Birth / / Age Sex Height Weight Address Street City State Zip Home Phone Cell Phone Work Phone Social Security Number Email Emergency Contact: Name &
UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California
CALIFORNIA UnitedHealthcare SignatureValue TM Offered by UnitedHealthcare of California HMO Schedule of Benefits 20/0% These services are covered as indicated when authorized through your Primary Care
Y0021_H4754_MRK1427_CMS File and Use PacificSource Community Health Plans, Inc. is a health plan with a Medicare contract
Y0021_H4754_MRK1427_CMS File and Use 08262012 PacificSource Community Health Plans, Inc. is a health plan with a Medicare contract Section I - Introduction to Summary of s Thank you for your interest in.
MASTERING SHARED DECISION MAKING
MASTERING SHARED DECISION MAKING The When, Why and How www.health.ebsco.com Overview One of the problems with the growing interest in shared decision making is that it is not very well understood. The
Implementing Patient Decision Aids for Increased Patient Engagement and Reduced Costs. David Arterburn MD, MPH Group Health Research Institute
Implementing Patient Decision Aids for Increased Patient Engagement and Reduced Costs David Arterburn MD, MPH Group Health Research Institute Financial disclosure I have received research funding and salary
can MAGIC SDM help? The extraordinary potential of primary care to improve mental health and wellbeing
The extraordinary potential of primary care to improve mental health and wellbeing can MAGIC SDM help? Dave Tomson GP, freelance consultant and Primary care lead for MAGIC Summary What characterises primary
Medicare Plus Blue SM Group PPO. Summary of Benefits. Michigan Public School Employees Retirement System
2018 Medicare Plus Blue SM Group Summary of Benefits January 1, 2018 December 31, 2018 Michigan Public School Employees Retirement System www.bcbsm.com/mpsers This information is a summary document and
Page 1 of 5 1/4/17. Print Guardian Name (If not patient) DOB: Circle One: - - Patients Name: (Last, First, MI):
Patients Name: (Last, First, MI): SSN: DOB: Circle One: Male Mailing Address: Apt. #: City: State: Zip Code: Female Race: Ethnicity Primary Language: Home Phone: Preferred? Cell Phone: Preferred? Employer:
BARIATRIC SURGERY SERVICES POLICY
BARIATRIC SURGERY SERVICES POLICY Please note that all Central Lancashire Clinical Commissioning Policies are currently under review and elements within the individual policies may have been replaced by
Incorporating Shared Decision Making into Informed Consent Documentation
Incorporating Shared Decision Making into Informed Consent Documentation Brynne Potter, CEO and Founder Maternity Neighborhood [Disclosure of Interest] Agenda Overview of standards for Informed Consent
Your Out-of-Pocket Type of Service
Calendar Year Deductible (CYD) 1 $3,000 single/ 3x family Out-of-Pocket Maximum - Deductibles and copays all accrue towards the out-of-pocket $6,200 single/ 2x family maximum. With respect to family plans,
$1,500 per individual $3,000 per family
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
Shared Decision Making
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Shared Decision Making