Information Quality Challenges in Shared Healthcare Decision Making

Abstract

Healthcare is evolving towards patient-centered care. Of particular interest is Shared Healthcare Decision Making (SHDM) defined here as a collaborative process of patients and physicians making healthcare decisions together, taking into account the best scientific evidence available, as well as the patients’ knowledge and preferences (Oshima Lee and Emanuel 2013). Compared to traditional decision-making based on authoritarian role of physicians, SHDM tends to be more sensitive to complex trade-offs of healthcare. Indeed, few healthcare decisions involve a clear optimal choice. For example, a man diagnosed with localized prostate cancer faces several choices. Surgery produces better urine flow at the risk of incontinence and impotence. Radiation therapy is nonsurgical, but it can cause long-term side effects and is also more expensive. Watchful waiting, while less expensive, can be catastrophic if cancer progresses rapidly. Relaying the clinical consequences of different options is traditionally in the hands of doctors, who generally steer people toward more aggressive treatments (Cutler 2014). With access to appropriate information about the trade-offs, it is believed, patients can take a more active role in their own care