Welcome to Better Decisions Together! A New Forum to Highlight Leading Research and Perspectives in Patient-Centered Clinical Decision Support
New eGEMs section seeks to realize the dream of genuine patient-centered clinical decision support.
Imagine the following ideal health care scenario:
- A conversation with your doctor informed by the best medical evidence, your own patient data, your preferences, and your values.
- The information is available precisely when you and your caregivers need it to help guide a pending medical decision, at a time that makes the most sense in light of the ongoing work that your health care professionals and you, as a patient, are doing.
- The information is delivered in formats that are easily understandable by your care providers and by you—available to streamline simple decisions or to support the shared decision-making discussions needed for more complex decisions.
- In short, decision support specifically designed to help providers and patients make better decisions together.
This scenario is our dream for genuinely patient-centered clinical decision support, and it’s a dream we’re inviting you to share through the new special section in AcademyHealth’s open access, peer-reviewed journal eGEMs. Titled Better Decisions Together, the new section is sponsored by the AHRQ-funded Patient-Centered Decision Support Learning Network.
As the new Better Decisions Together section editor, I’ll help eGEMs provide a forum for ongoing research and practice in patient-centered clinical decision support. As an informatics researcher, working in close collaboration with health systems, I have studied patient decision-making and health literacy, as well as physician decision-making and health care quality. I’m eager to support the innovative use of technology to deliver better care.
However, my work has also given me a keen awareness of how information technology can sometimes make things worse instead of better. I’ve published on the heavy information burdens faced by patients trying to manage, share, and correct their own medical information, and on the well-established problem of provider alert fatigue stemming from deluges of interruptive alerts. Patient-centered clinical decision support (PCCDS) cannot succeed if it simply interrupts workflow with more and more complex systems of alerts and reminders. I believe that many of the most valuable innovations will come from novel ways to reduce complexity, not add to it, and from maximizing system fit to the work and cognitive needs of the people who use it.
PCCDS will also need to continue to improve how it involves patients as stakeholders and decision makers through better patient-provider communication. This includes all the various aspects of sharing information – from reporting history, outcomes, and symptoms to discussing preferences and values, as well as cost implications of medical choices. Providers must begin to work more closely with patients to generate and share data through portals, phones, and medical devices; understand and explain genetic information and other complex medical concepts; and receive output of decision support in the form of decision aids and educational materials. To accomplish these goals, PCCDS innovators will need to engage with health literacy, health numeracy, and usability challenges, as well the complex and variable ways patients do the routine work of managing their own health and illnesses within their homes and workplaces.
A major challenge is to meet the information needs of the substantial proportion of people who do not have a smartphone (nearly one-quarter of Americans) or use the internet at all (more than 10 percent in the United States). These less technologically experienced individuals are more likely to be poor and low in literacy or English proficiency. Because poverty is such a strong predictor of poor health, these patients are also likely to be in medical need. If we do not solve the challenge of engaging these patients in PCCDS, then PCCDS will leave behind many of the patients most in need of assistance, widening disparities instead of promoting health equity.
The best way to address these challenges is to create a forum for innovators, practitioners, researchers, and patients to share their findings, discuss their commonalities and differences, and learn from each other. Given the talent and resources we can bring to bear on these problems, I am confident that we can make a tremendous amount of progress by working together. That’s the goal of Better Decisions Together.
Our initial call for papers is now open. I can’t wait to see what we accomplish. Together.
Jessica Ancker Named Editor of New eGEMs Section on Patient-Centered Clinical Decision Support
An expert on facilitating good decisions through health information technology, Ancker has studied both patient decision making and clinical decision support, and brings valuable expertise to this new role.
By: Lauren Adams
The Patient-Centered Clinical Decision Support Learning Network is pleased to announce Jessica S Ancker, Ph.D., M.P.H., as the editor of a new special section in AcademyHealth’s peer-reviewed open access journal, eGEMs. Ancker is associate professor of healthcare policy & research at Weill Cornell Medicine, within the division of health informatics. Ancker’s expertise in facilitating good decisions through health information technology makes her the perfect editor for eGEMs’ new section called Better Decisions Together: Decision Support for Patient-Centered Healthcare.
“With all the progress in recent years around electronic health records and patient portals, many of the pieces are now in place to ensure that patients understand the clinical perspective and evidence base for their decisions, and that the clinician understands the patient’s priorities and preferences,” said Ancker. “I’m honored to be part of this effort to advance collaboration between patients and clinicians – to put them on the same team for better outcomes.”
The new section is the fruit of a partnership between eGEMs and the Patient-Centered Clinical Decision Support Learning Network, hosted by RTI International and funded by the Agency for Healthcare Research and Quality (AHRQ). Clinical Decision Support, a process for enhancing health-related decisions and actions including software-based solutions, plays a critical role in making key patient-centered outcomes research findings accessible and actionable. The Learning Network aims to build a community dedicated to developing and implementing solutions that leverage clinical decision support technology and patient-centered evidence to improve patients’ and providers’ care decisions.
“We are excited about the potential of this new special section to share promising research on patient-centered approaches to clinical decision support in an open and accessible environment,” said Barry Blumenfeld, M.D., M.S., senior informaticist at RTI and principal investigator for the Learning Network. “Having Jessica on board to lead the section only fuels that excitement.”
The section’s inaugural call for papers is now open through
Jan. 31, 2018 February 16, 2018.
“We are delighted to have someone with Jessica’s background and insight join one of AcademyHealth’s critical efforts to accelerate learning at this time of innovation in health data and systems,” said eGEMs executive editor Paul Wallace. “I know under Jessica’s leadership the Better Decisions Together section will serve to raise the visibility of work aimed at ensuring learning health systems are indeed patient-centered.”
After receiving an AB degree magna cum laude in history and science from Harvard University, Ancker initially pursued a career in journalism and medical writing and editing. She then earned a Master of Public Health from the department of biostatistics at Columbia University’s Mailman School of Public Health in 2004. She went on to complete a Ph.D. at Columbia University College of Physicians and Surgeons in 2009 as a National Library of Medicine/Robert Wood Johnson Predoctoral Fellow in the Department of Biomedical Informatics. Ancker joined Weill Cornell Medicine in 2009, and since 2011 she has also held a faculty position in the Weill Cornell Graduate School of Medical Sciences.
Ancker will join the eGEMs editorial board of experts from across the country who help lead the premier journal for approaches to redesigning the health system, including methods, interoperability, and governance. Visit the eGEMs website to learn more about the journal and review the current call for papers here.
Tags: Using Health Data; Delivering Better Care; News
New Special Section on Patient-Centered CDS
The PCCDS Learning Network, an RTI International-hosted project, is launching a a special section on patient-centered CDS within eGEMs, an open access, peer-reviewed on-line journal. The special eGEMS section will disseminate new methods and strategies that advance the science of patient-centered clinical decision support— from comparative effectiveness research, patient-centered outcomes research, and quality improvement studies— using electronic health data and evidence.
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In the Press
RTI's press release on this announcement can be found here.
And a description of the collaboration is also available on the AcademyHealth site here.