The New Era of Informed Consent

Getting to a Reasonable-Patient Standard Through Shared Decision Making

Erica S. Spatz, Harlan M. Krumholz, MD, Benjamin W. Moulton
JAMA. 2016; 315(19):2063-2064. doi:10.1001/jama.2016.3070.

Here is an excerpt:

Informed consent discussions are often devoid of details about the material risks, benefits, and alternatives that are critical to meaningful patient decision making. Informed consent documents for procedures, surgery, and medical treatments with material risks (eg, radiation therapy) tend to be generic, containing information intended to protect the physician or hospital from litigation. These documents are often written at a high reading level and sometimes presented in nonlegible print, putting a premium on health literacy and proactive information-seeking behavior. Moreover, informed consent documents are often signed minutes before the start of a procedure, a time when patients are most vulnerable and least likely to ask questions—hardly consistent with what a reasonable patient would deem acceptable. In the United States, with the exception of 1 state, Washington, that explicitly recognizes shared decision making as an alternative to the traditional informed consent process, the law has yet to promote a process that truly supports a reasonable-patient–centered standard through shared decision making.

The article is here.

Familiarity breeds doctor contempt with EHRs

Experts say meaningful use is contributing to the growth of electronic health record systems, but it also has a negative effect on EHR user-friendliness.

By Pamela Lewis Dolan
amednews.com
Originally published March 18, 2013

The meaningful use incentive program has resulted in more physicians implementing electronic health record systems and using them in advanced ways. Yet doctors' dissatisfaction with the systems has increased.

Theories for what is driving the dissatisfaction include rushed implementations, too little training and physicians doing too much too soon as they struggle to meet meaningful use requirements, other federal mandates and changes to the health care landscape. EHR vendors also are thought to be taking on too much in too little time. As they rush to deliver products certified for meaningful use, usability may have suffered.

A survey by AmericanEHR Partners of 4,279 clinicians, including primary care physicians, specialists and diagnostic professionals, found that user satisfaction declined from 39% in 2010 to 27% in 2012. The rate of those “very dissatisfied” increased from 11% to 21% during the same period. The findings were presented in March at the Healthcare Information and Management Systems Society annual conference in New Orleans.

The entire article is here.