|
Shared Decision-MakingShared decision-making should recognize that every patient is different, so what works best for one patient may not work for someone else. That's why comparative clinical effectiveness research, or patient-centered outcomes research, should focus on making research widely available to decision-makers, but shouldn't make policy recommendations or decisions itself – that could lead to one-size-fits-all policies that ignore how people are different. New investments in research, such as the work of the Patient-Centered Outcomes Research Institute (PCORI), should be implemented to promote shared decision-making between patients and providers and empower them to apply research results to their unique situation.
|
This is also why it is important for research results to be communicated quickly and accurately, and in ways that help doctors and patients apply results to the individual's circumstances. This means discussing the different factors that can help decide which treatment is optimal for the individual, like the patient's particular medical condition and genetic variations.
Outcomes That Matter to Patients |
To improve patient care, shared decision-making tools should be developed and tested in consultation with patients to ensure that they are actually empowering patients in their health care. This means comparative clinical effectiveness research should examine the range of issues that affect the quality of patient care, from medical tests and treatments, to questions related to health care delivery and organization, such as benefit designs and care management programs. All of these elements of health care affect patients' quality of care and health outcomes.
In addition, research should include the different factors important to patients, including quality of life, independence, and productivity. Information disseminated from those studies must be accessible and understandable to patients through shared decision-making tools that patients to personalize their care decisions, as opposed to supporting “one size fits all” care decisions. Ultimately, health care payment and delivery systems must also incentivize the actual use of shared decision-making tools by both patients and providers, and allow for individualized treatment decisions. |
Individualized Patients |
Every patient is different, so it is very important for health systems to support personalized care. Comparative clinical effectiveness research should therefore be designed, communicated and used in ways that recognize individual patient differences. Traditional comparative effectiveness research (CER) typically focuses on population averages, not differences in individuals. Comparative clinical effectiveness research should reflect the differences in patients based on factors such as genetics, health status, and their environment. This will help ensure that CER reflects patients’ individual circumstances rather than encouraging one-size-fits-all solutions based on averages.
Personalized medicine and other advances in treatment methodologies can help improve patient care. The emerging science of personalized medicine challenges us to incorporate the principles of patient-centeredness throughout the healthcare system. Advances in genetics and other fields like health information technology are giving physicians powerful new tools to understand which treatments are likely to work best on which patients. These advances hold potential to improve patient care and health care value. Truly evidence-based medicine will reflect these differences. Ultimately, health systems should facilitate the ability of physicians to tailor treatments to the needs of individual patients based on genetic information, quality of life preferences, and other factors. |
