Health care consumers and providers of care have pushed-back significantly when attempting to introduce protocols or decision making tools in the process. The thought being you cannot reduce something as complex as health care to a series of algorithms.
Two books provide some indication that the emphasis on standardized decision making in health care will not go away. The research cited, in-fact, provides credibility that by using simple decision making methodologies outcomes may improve, may cost less, and provides more transparency to varous stakeholders throughout the system.
The Checklist Manifesto, by Harvard surgeon and New Yorker staff writer Atul Gawande, M.D. introduces the simple idea of using “checklists” as part of the care delivery process. His premise is simple- no matter how much of an expert you may be, you can always improve your outcome with well designed checklists to guide you through the key steps of any complex procedure. Click here to go to Gawande's web site- he's got some cool checklists already developed.
While Gawande believes his checklist idea is applicable for many other areas of life, his experience in the health care field lends credibility to his argument for designing simple methods to assist in the decision making process resulting in better outcomes and lower costs over time.
Thomas Goetz, a journalist and Executive Editor of Wired Magazine presents a different approach- but this time for health care consumers.
His book, The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine introduces a methodology to assist individuals in making health care decisions. Much like Gawande argues in The Checklist Manifesto, Goetz recognizes the decisions we make today are much more complex than ever before. Health care consumers are usually left to their own devices to acquire the information they need to make decisions concerning their health and are at the mercy of the health care system when confronted with it. The Decision Tree presents a method and device for individuals to formalize health care decisions and externalize the choices made in their health and health care they typically make without thinking. The studies he cites confirm the fact that those individuals who actively participate in the decision making process are more engaged, and achieve better results. Click here to go to the Decision Tree web site. Take a look at the video to get a better idea of the concept.
Our health care system has been fighting the battle of “protocols” and processes for many years. While one side recognizes the possibilities for improved efficiency the other side views them as barriers that obstruct the delivery of care and the relationship with the patient. Consumers are accessing and becoming overwhelmed with a growing body of research and information (both good and bad) from which to base their decisions- and have not always been welcomed when trying to participate in the decision making process.
With such a significant amount of money being wasted in our health care system the need to at least set a framework for making decisions by all stakeholders will only increase. Gawande and Goetz provide some food for thought with some simple ideas to consider with the support behind them to show that outcomes will improve, engagement will increase, and costs will go down.
They are certainly worth a good discussion at the water cooler.
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