April 15, 2016
Making decisions about healthcare options can seem overwhelming to patients and their families, and, in many cases, patients are asked to make decisions even though they have a limited understanding of their options. The Decision Counseling Program (DCP) is an online software application that enables patients to make well-informed healthcare decisions together with their treating physicians.
Ronald E. Myers, DSW, PhD, Professor of Medical Oncology, and Constantine Daskalakis, ScD, Associate Professor, Department of Pharmacology and Experimental Therapeutics, believe that high-quality medical decisions require patients to be fully informed and involved in their decision-making process. The two have created an innovative patient engagement process that may help to redefine clinical excellence in patient care — and in doing so are helping Jefferson achieve its “patients and families first” goal as part of our Blueprint for Strategic Action.
“When patient knowledge and understanding increase, there is better physician-patient communication and improved clinical outcomes, plus patient anxiety decreases while satisfaction increases,” said Dr. Daskalakis about the application.
Through the Center for Health Decisions at TJU, Drs. Myers and Daskalakis have developed a new online software application, which provides a more patient-engaged care experience. Known as the Decision Counseling Program (DCP), this new patient-engagement tool incorporates a systematic presentation of information about medical options with an assessment of the patient’s emotional responses and preferences. It is designed to amplify the voice of the patient by electronically gathering and analyzing data, then presenting treatment options that are fully understood and make sense to the patient.
“We developed easy-to-follow steps in this software application that help patients learn about their medical conditions, understand their options, and gain insight into the pros and cons relating to those options,” explained Dr. Myers.
According to Drs. Myers and Daskalakis, flexibility and ease of navigation are the prevailing features of DCP. Additionally, since it was designed to be generic, DCP can accommodate any health decision.
The Education Process
The education session begins when a trained counselor — a health worker, social worker, nurse or physician — accesses the online program (either in person or via phone with the patient), reviews educational material about health decision options with the patient, and addresses questions and concerns that he or she may have.
The counselor uses a structured guide to help the patient identify and weigh factors that are likely to influence his/her decision. These “decision factors” may favor one decision option over another, and may have differential weight in the patient’s decision-making process. The patient’s responses are then interactively entered into the online program.
At the end of the session, the program produces a graphical display of the patient’s decision preference, which is compiled into a one-page report. That report lists the patient’s most important decision factors, his/her preferred decision, and additional questions or concerns. This report can also be added to the individual’s medical record for use in shared decision-making.
See an example of the final graphical summary as it appears on portable media.
The application is currently being used in the Jefferson Lung Cancer Screening Program and in collaboration with a regional colorectal cancer-screening program that involves the Lehigh Valley Health Network. It has been used to facilitate treatment decision-making for men with localized prostate cancer, as well as help patients make decisions about clinical trials participation. Furthermore, the program can be used with individuals not currently being treated by a physician, but who would like assistance in making various medical or behavioral decisions.
The team hopes to expand the program’s capabilities to include a patient-administered application and a streamlined version that is responsive on handheld devices. Drs. Myers and Daskalakis also anticipate making the system seamlessly interface with an institution’s medical records, which would replace the need for documents to be scanned and then placed in a patient’s file.