The use of PROMs and shared decision‐making in medical encounters with patients: An opportunity to deliver value‐based health care to patients

Background The recent emphasis on value‐based health care (VBHC) is thought to provide new opportunities for shared decision‐making (SDM) in the Netherlands, especially when using patient‐reported outcome measures (PROMs) in routine medical encounters. It is still largely unclear about how PROMs cou...

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Bibliographic Details
Published in:	Journal of evaluation in clinical practice Vol. 26; no. 2; pp. 524 - 540
Main Authors:	Damman, Olga C., Jani, Anant, Jong, Brigit A., Becker, Annemarie, Metz, Margot J., Bruijne, Martine C., Timmermans, Danielle R., Cornel, Martina C., Ubbink, Dirk T., Steen, Marije, Gray, Muir, El, Carla
Format:	Journal Article
Language:	English
Published:	England Wiley Subscription Services, Inc 01.04.2020 John Wiley and Sons Inc
Subjects:	Decision Making Decision Making, Shared Delivery of Health Care Humans Netherlands Patient care planning Patient Participation Patient Reported Outcome Measures Patient satisfaction Physician patient relationships routine outcome monitoring Shared decision making Special Issue Special Issues value‐based health care Netherlands value-based health care patient-reported outcome measures routine outcome monitoring shared decision-making
ISSN:	1356-1294, 1365-2753, 1365-2753
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Summary:	Background The recent emphasis on value‐based health care (VBHC) is thought to provide new opportunities for shared decision‐making (SDM) in the Netherlands, especially when using patient‐reported outcome measures (PROMs) in routine medical encounters. It is still largely unclear about how PROMs could be linked to SDM and what we expect from clinicians in this respect. Aim To describe approaches and lessons learned in the fields of SDM and VBHC implementation that converge in using PROMs in medical encounters. Approach Based on input from three Dutch forerunner case examples and available evidence about SDM and VBHC, we describe barriers and facilitators regarding the use of PROMs and SDM in the medical encounter. Barriers and facilitators were structured according to a conversational model that included monitoring and managing, team talk, option talk, choice talk, and decision talk. Key lessons learned and recommendations were synthesized. Results The use of individual, N = 1 PROMs scores in the medical encounter has been largely achieved in the forerunner projects. Conversation on monitoring and managing is relatively well implemented, and option talk to some extent, unlike team talk, and decision talk. Aggregated PROMs information describing outcomes of treatment options seemed to be scarcely used. Experienced barriers largely corresponded to what is known from the literature, eg, perceived lack of time and lack of tools summarizing the options. Some concerns were identified about increasing health care consumption as a result of using PROMs and SDM in the medical encounter. Conclusion Successful implementation of SDM within VBHC initiatives may not be self‐evident, even though individual, N = 1 PROMs scores are being used in the medical encounter. Education and staff resources on meso and macro levels may facilitate the more time‐consuming SDM aspects. It seems fruitful to especially target team talk and choice talk in redesigning clinical pathways.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Correction added on 6 February 2020, after first online publication: Figures 2 and 3 were mistakenly switched. These have been corrected in this version.
ISSN:	1356-1294 1365-2753 1365-2753
DOI:	10.1111/jep.13321