Q&A: Health Dialog empowers patients, practitioners through SDM tool

BOSTON — Health Dialog, a leading provider of integrated population health management solutions for health plans, risk-bearing providers and self-insured employers, recently hosted a complimentary webinar where Peter Goldbach, the company’s chief medical officer and a national authority on shared decision-making, provided strategic advice to help organizations execute effective shared decision-making programs that reduce costs, improve outcomes and increase patient satisfaction.



Sound interesting? We thought so, too. So Drug Store News reached out to Goldbach to get a better understanding of shared decision-making and its role in the marketplace. Here’s what he had to say:



Drug Store News: What is shared decision-making? How can retail pharmacy operators learn more about the clinical application?



Peter Goldbach: Shared decision-making is a process which seeks to empower patients with an evidence-based, non-biased understanding about their condition [and] treatments and an invitation for the patients to think about their own lifestyles, values and preferences so that they would be able to weigh in as they interact with their doctors. The process is meant to help the patient have a better, more informed interaction with their provider and with that provider, make a decision as to what’s best for them.



There are a couple of resources available on shared decision-making, not the least of which is a white paper that was just put out this month by the National Quality Forum. It’s a call to action to make sure shared decision-making is a standard of care for all patients. They also issued a more in-depth white paper in December 2016 that talks about Shared Decision Making and certifying decision aids, making for a high-quality shared decision-making patient interaction.



DSN: So for those patients who only get 15 minutes with their primary care physician, this tool enables them to engage in a deeper conversation around their condition with a practitioner?



Goldbach: There’s a lot of knowledge to absorb so having a resource to help patients get prepared—so that the nomenclature doesn’t throw them off or the anatomy is not strange to them—is helpful. In order to accomplish those goals, we use different strategies. One of the strategies is a shared decision-making aid, like an audio-visual booklet that explains these things and introduces the patient to other patients like them who are talking about their condition. Now when they go to their provider, they have a foundation for their discussion. We also have nurse coaches who talk to people and help those patients with their strategy.



DSN: What are the audio-visual booklets?



Goldbach: These are shared decision-making aids and they’re very important because there is often a lot of information that patients need to absorb to become informed. We found the combination of using real patients and real doctors in videos coupled with the text-based explanations of the facts and unbiased estimates of benefits and risks to be an effective way of sharing complex information. We’ve been doing this for 20 years. We are very aware that providers are very particular about having other people talking to their patients. We are very careful to be entirely fact-based and use Harvard Medical School as our review arm. Every year or two, each aid is reviewed by them. And each aid has a bibliography so providers know where we source our statistics from.



DSN:  How is shared decision-making coming to fruition in the market?



Goldbach: There is a generalized disruption in the market where we are moving gradually toward a fee-for-value based model. We’re on a path and we’re not going back. The fee-for-service model is not sustainable in the long run and we need to set goals that bring us to a better place. We know that [the market] is twice as expensive [as compared to] Europe and only half as good in terms of quality. The notion of converging around these new set of values that are now being expressed in [payer] contracts is going to be necessary. In that marketplace, one of the disruptors has been retail, offering high-value, low-cost convenient care for a limited set of problems. As the market moves to fee-for-value, we now find that providers see real value in having this low-cost option, and it’s an option that can make their patient network larger and more patient-centric.  



DSN: What’s the bottom line? What’s the one takeaway on shared decision-making our readers should come away with?



Goldbach: This change to value creation is the jewel in the crown. It’s the right focus for us all to create true value and [be compensated] for taking great care of the populations we serve. It’s encouraging to see providers and health plans thinking this is the way the market is going to move. As medicine is getting more complex, it’s also relying more on team-based care. It’s going to become very comfortable for providers to realize they have these nurse coaches to spend time with patients and help them get a better understanding on how to take better care of themselves. They have a system that can help people facing complex medical choices get informed and have coaching. For those unscheduled illnesses, you need unscheduled access to care, and retail has been providing that. As medicine is evolving, we now have a bigger team and it’s going to help.



Health Dialog posted a recent white paper on the company’s SDM services here.