Decision guides’ help patients make choices
Service enables greater care management role
Using the Internet, health care institutions can affect quality of care far beyond the boundaries of their own patient populations. The Mayo Clinic in Rochester, MN, has done just that with the creation of a series of "decision guides" offered free of charge on its web site: www.mayoclinic.com. Since the guides are located on a public domain, any patient anywhere in the world has access to them. They walk patients through a detailed description of their condition and offer the pros and cons of screenings, surgery, and other treatment options.
The guides include color graphics, anatomical drawings, and, in some instances, videos of different procedures. (For a content sample, see "ACL Injuries: What’s Best for Me?" in this issue.) At present, Mayo offers guides for:
- early stage breast cancer;
- knee injuries (ACL);
- children’s middle ear infections;
- herniated discs;
- colorectal cancer.
"We launched our site in November 2000," recalls Nicole Spelhaug, editor in chief of MayoClinic.com. "The clinic itself had been on the Internet since 1995, but last year we launched many new offerings including the decision guides for early breast cancer, ACL, and middle ear infections."
Spelhaug’s predecessor had been involved in similar types of web content at Dartmouth University, she notes, and "wanted to re-create it" for Mayo. "Our mission is to help people better manage their health care," she says. "When it comes to this particular type of content, these guides can be very helpful. People are faced with tough decisions every day, and they don’t often know which [choice] they should make. They can get advice from their doctor, but it helps improve communication when they are more informed, can ask more and better questions, and can understand the answers they get," Spelhaug says. "The whole reason for these guides is to help people who are at health-related crossroads make informed decisions."
Not one person’s decision
Spelhaug says she firmly believes such decisions should not be left to one person alone; i.e., the physician. "I don’t believe they are supposed to do that by [themselves]. It’s the whole philosophy that people need to be involved in their own health care, and to do so they need to be informed and know what their choices are," she points out. "These guides cover topics for which there are clear alternatives but no clear-cut best procedure. Patients need to know the pros and cons and weigh them for themselves. No one can make that decision for them."
What other benefits do the guides offer? "My sense is that this is a huge benefit in terms of patient satisfaction," she asserts. We have some qualitative, unsolicited feedback that is overwhelmingly positive; patients are very expressive and extensive in terms of the feedback they give us about the benefits of this kind of information."
Spelhaug and her staff have not yet conducted formal surveys, but plans are in the works. "We are in the process of annual updating for our original three guides, and at that time we will implement a user satisfaction survey," she says. "We’ll ask if they were easy to understand, if they gave patients the answers they needed, if [the guides] increased their confidence in their ability to make decisions, and if they helped to improved communication with their physician," Spelhaug says.
How will guides affect quality of care?
Does she see an impact on quality of care? "It certainly should enhance the quality of the experience," she says. "It could also help contain costs; if people become more aware of their options and can make informed choices, they won’t necessarily decide that the most expensive or radical option is best for them," Spelhaug points out. "We often see that in conditions like early breast cancer, where women may not understand the therapeutic benefits of lumpectomy," she adds.
Need more information?
For more information, contact: Nicole Spelhaug, Editor in Chief, MayoClinic. com, 200 First St. S.W., Rochester, MN 55905. Telephone: (507) 284-9367.
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