A major initiative in medicine today is the concept of Patient Centered Care. This is an evolution of aspect, with one initiative being Shared Decision Making. SDM was formalized in the 1990’s and is partly predicated on fully understanding the patient’s values and preferences. In other words, patient centered. A key issue here is that to be Patient Centered, one needs tools that are patient first, not designed for physicians to work with patients. EZSDM is a Shared Decision-Making tool designed for patients to inform their physicians, not physicians to work with patients.
The biggest problem today with SDM is the lack of tools available. Looking over existing material, especially toolkits identified by NIH, these tools are mostly documents, PowerPoints, and videos designed for physicians on how to have successful SDM discussions with patients. Think of it as trying to teach bedside manner. Looking at the Mayo Clinic Shared Decision-Making resource center webpage, the tools available there are presented as flashcards. It's 2018, where are our modern tools? The most important thing about SDM is having the discussion. A major obstacle in discussion with patients is to overcome the fog and distraction of dealing with the diagnosis. In cinema, the Breaking Bad "mustard scene" or the "50/50 diagnosis scene" show insights into this issue. Not having Patient Centered Tools makes this discussion much harder to accomplish successfully.
Additionally, speaking as someone with extensive patient experience, the existing documented workflows and best practices are flawed. They specify to invite patients for a discussion to present options with their pros and cons. However, if physicians don’t fully understand the patient’s priorities, and if the patients don’t fully understand their own priorities, then this discussion is handicapped from the beginning. It really is Physician Bias (though non-intentional) being presented. Another word for this is being Centric, but not Centered. EZSDM provides a competitive advantage in the form of a groundbreaking patient-centered application for SDM.
What if when entering a Shared Decision-Making discussion, the patient had graphs such as these to present to their physician? Wouldn't that bring a whole different dimension to the discussion? If we are going to have Patient Centered Medicine, shouldn’t we have apps that are designed for the patient to work with physicians instead of designed for physicians to work with patients?
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